Individual
MR. JEFFREY BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
3210 ROCK BLUFF DR, DALLAS, TX 75227-5649
(214) 364-6769
Mailing address
3210 ROCK BLUFF DR, DALLAS, TX 75227-5649
(214) 364-6769
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00755
TX
Other
Enumeration date
06/14/2009
Last updated
08/26/2019
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