Individual
DR. JANE EMILY BOOZALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2411 FOUNTAIN VIEW DR, SUITE 200, HOUSTON, TX 77057-4817
(713) 458-4185
Mailing address
2411 FOUNTAIN VIEW DR STE 200, HOUSTON, TX 77057-4817
(713) 620-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H5404
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050041646
RAILROAD MEDICARE
TX
05
—
129873902
—
TX
05
—
1818968
—
LA
01
—
84Y528
TX-BLUE SHIELD
—
Enumeration date
01/04/2007
Last updated
03/08/2010
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