Jerry E Bouquot, DDS | |
6516 Md Anderson Blvd, Rm #3.094f, Houston, TX 77030 | |
(866) 446-4936 | |
(713) 450-3988 |
Full Name | Jerry E Bouquot |
---|---|
Gender | Male |
Speciality | Maxillofacial Surgery |
Experience | 53 Years |
Location | 6516 Md Anderson Blvd, Houston, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457494460 | NPI | - | NPPES |
P00305690 | Other | MEDICARE RAILROAD CARRIER | |
89D241 | Other | TX | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0101X | Pathology - Anatomic Pathology | 22003 (Texas) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
West Virginia University Dental Corporation | 1850370586 | 5 |
Entity Name | West Virginia University Dental Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720097637 PECOS PAC ID: 1850370586 Enrollment ID: O20040716000308 |
Mailing Address | Practice Location Address |
---|---|
Jerry E Bouquot, DDS 6516 Md Anderson Blvd, Rm #3.094f, Houston, TX 77030 Ph: (866) 446-4936 | Jerry E Bouquot, DDS 6516 Md Anderson Blvd, Rm #3.094f, Houston, TX 77030 Ph: (866) 446-4936 |
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