Individual
MR. MICHAEL CHARLES BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
31003 SHERRIE LN, MAGNOLIA, TX 77354-5793
(281) 460-3120
(281) 259-0879
Mailing address
31003 SHERRIE LN, MAGNOLIA, TX 77354-5793
(281) 460-3120
(281) 259-0879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
009868L
LA
183500000X
Pharmacist
19119
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
501613
TX
367500000X
Certified Registered Nurse Anesthetist
RN051202
LA
Other
Enumeration date
08/16/2005
Last updated
08/10/2010
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