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

Olivia Gayle Boggan

Individual provider Physician Assistant · NPI 1952086274

Olivia Gayle Boggan is a Physician Assistant in Shenandoah, Texas. Qualified in 2023, 3 years ago. Practices with Privia Medical Group Gulf Coast PLLC, a 538-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
3
In the registry since
2023
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Practice location Address checks out

134 Vision Park Blvd Ste 300
Shenandoah, TX 77384-3032
Phone: (281) 296-8500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1952086274
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 15, 2023
Last updated in NPPESJune 15, 2023
Certification dateJune 15, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Privia Medical Group Gulf Coast Pllc — 538 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Shenandoah