Individual
DR. JUSTIN EDWARD BOATSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8401 DATAPOINT DR STE 600, SAN ANTONIO, TX 78229-5907
(210) 616-7700
(210) 616-7709
Mailing address
8401 DATAPOINT, SUITE 600, P. O. BOX 29441, SAN ANTONIO, TX 78229-0441
(210) 616-7796
(210) 616-7799
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
P2598
TX
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
P2598
TX
2085N0700X
Neuroradiology Physician
P2598
TX
2085N0904X
Nuclear Radiology Physician
P2598
TX
2085P0229X
Pediatric Radiology Physician
P2598
TX
2085R0001X
Radiation Oncology Physician
P2598
TX
2085R0202X
Diagnostic Radiology Physician
Primary
P2598
TX
2085R0203X
Therapeutic Radiology Physician
P2598
TX
2085R0204X
Vascular & Interventional Radiology Physician
P2598
TX
2085R0205X
Radiological Physics Physician
P2598
TX
2085U0001X
Diagnostic Ultrasound Physician
P2598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3011801-01
—
TX
05
—
3011801-02
—
TX
05
—
3011801-03
—
TX
01
—
P01066188
RAILROAD MEDICARE
TX
01
—
P01070221
RAILROAD MEDICARE
TX
01
—
P2598
TEXAS MEDICAL LICENSE
TX
Enumeration date
06/14/2007
Last updated
03/24/2016
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