Boulware, Terry A

Boulware, Terry A is an sole proprietor health care provider with primary practice located at 2525 S Telshor Blvd Bldg 14, Ste 102, Las Cruces NM 88011-5071. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Boulware, Terry A can be contacted via phone (505) 522-7247.

Contact Information

Primary practice address
2525 S Telshor Blvd Bldg 14, Ste 102 Las Cruces NM 88011-5071
Phone: (505) 522-7247
Fax: (505) 522-2029
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD2005-0138 New Mexico

Profile Details

NPI number 1730112558
LBN Legal business name Boulware, Terry A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2006
Last updated Sep 25th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730112558 NPPES
New Mexico MEDICAID 33087512
New Mexico Other NM009V60

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