Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael Glen Boulos

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1730020967

Dr. Michael Glen Boulos is a Student in an Organized Health Care Education/Training Program in San Antonio, Texas. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

2133 Pepperrell St Bldg 3352
San Antonio, TX 78236-5313
Phone: (210) 292-6258
Fax: (210) 292-6258
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1730020967
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 2, 2026
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026
Mailing address2133 Pepperrell St Bldg 3352, Jbsa Lackland, TX 78236-5313

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