Dr. Michael Glen Boulos
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 3352San Antonio, TX 78236-5313
Phone: (210) 292-6258
Fax: (210) 292-6258
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1730020967 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 2, 2026 |
| Last updated in NPPES | August 3, 2026 |
| Certification date | August 3, 2026 |
| Mailing address | 2133 Pepperrell St Bldg 3352, Jbsa Lackland, TX 78236-5313 |
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