Individual provider · Type 1 NPI

Michael Glen Boulos

Student in an Organized Health Care Education/Training Program · San Antonio, TX

NPI number 1730020967 Active

Practice location

2133 Pepperrell St Bldg 3352
San Antonio, TX 78236-5313

Call (210) 292-6258 Map

Fax (210) 292-6258

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1730020967

Michael Glen Boulos's National Provider Identifier is 1730020967, issued on Apr 2, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Antonio, TX. The record was last updated on Aug 3, 2026.