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Individual

EUGENE V BOISAUBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6410 FANNIN ST, 600, HOUSTON, TX 77030-3000
(832) 325-7100
Mailing address
PO BOX 301448, DALLAS, TX 75303-1448
(713) 500-3500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E4805
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149968301
TX
01
149968302
CSHCN
TX
01
8B8753
BCBS
TX
Enumeration date
07/10/2006
Last updated
07/29/2016
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