Individual
DR. MAROUANE R. BOUCHAREB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036.119871
IL
2085R0202X
Diagnostic Radiology Physician
Primary
55393
GA
2085R0204X
Vascular & Interventional Radiology Physician
036119871
IL
Other
Enumeration date
01/10/2008
Last updated
01/12/2015
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