| Susan L. Boullioun, M.d., P.a. | |
|
113 E. Cedar St. Seguin TX 78155-3709 | |
| (830) 303-3500 | |
| (830) 303-9399 |
| Full Name | Susan L. Boullioun, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 113 E. Cedar St., Seguin, Texas |
| Authorized Official Name and Position | Susan Lorton Boullioun (PRESIDENT) |
| Authorized Official Contact | 8303033500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan L. Boullioun, M.d., P.a. 113 E Cedar St Seguin TX 78155-3709 Ph: (830) 303-3500 | Susan L. Boullioun, M.d., P.a. 113 E. Cedar St. Seguin TX 78155-3709 Ph: (830) 303-3500 |
| NPI Number | 1588801609 |
|---|---|
| Provider Enumeration Date | 01/12/2009 |
| Last Update Date | 01/07/2010 |
| Medicare PECOS PAC ID | 1557419611 |
|---|---|
| Medicare Enrollment ID | O20090429000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588801609 | NPI | - | NPPES |
| 121420704 | Medicaid | TX | |
| 121420702 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K2312 (Texas) | Primary |
| Provider Name | Susan L Boullioun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528148889 PECOS PAC ID: 0547318792 Enrollment ID: I20090428000480 |
Tony N Tsen Md Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 911 S State Hwy 123 Bypass, Seguin, TX 78155 Phone: 830-372-9042 Fax: 830-372-2391 | |
James C Lee Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 N King St Ste 102, Seguin, TX 78155 Phone: 830-379-7901 Fax: 830-401-0737 | |
Arlynn H Hartfiel Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 N King St Ste 103, Seguin, TX 78155 Phone: 830-372-1980 Fax: 830-372-2930 | |
Phillip C Rinn Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 N King St, Suite 107, Seguin, TX 78155 Phone: 830-372-0994 Fax: 830-379-3049 | |
Seguin Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1104 Jefferson St., Seguin, TX 78155 Phone: 830-379-9797 Fax: 830-379-0248 | |
Geronimo Village Pediatrics, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Dennis Dr, Seguin, TX 78155 Phone: 830-372-8981 Fax: 830-372-8984 | |
Edward A Balli, Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 E Walnut St, Suite 400, Seguin, TX 78155 Phone: 830-379-6823 Fax: 830-379-3898 |