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

Nathalie Boulos, MD

Individual provider Psychiatry Physician · NPI 1548714397

Nathalie Boulos, MD is a Psychiatry in Waco, Texas. Qualified in 2014, 12 years ago. Practices with Providence Health Alliance, a 122-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Missouri and Texas.

Years since qualifying
12
Licensed in
MO, TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

301 Londonderry Dr
Waco, TX 76712-7915
Phone: (254) 751-4880
Fax: (254) 751-4885
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence S9270 (TX)
Psychiatry Physician Taxonomy 2084P0800X · Licence 2019024539 (MO)

Record details

NPI number1548714397
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 10, 2016
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023
Mailing address301 Londonderry Dr, Waco, TX 76712-7915

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Providence Health Alliance — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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