Meryl Lee Boutte, CAA
Anesthesiologist Assistant in Waco, TX. Individual provider (NPI-1).
NPI number1376100875
StatusActive
Last updated in NPPESDec 6, 2021
Details
- NPI
- 1376100875
- Entity type
- Individual (NPI-1)
- Name
- Meryl Lee Boutte
- Credential
- CAA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 21, 2019
- Certification date
- Dec 6, 2021
- Last updated
- Dec 6, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - ANESTHESIOLOGY ASSISTANT
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 29649094 | TX | Yes |
| 207L00000X | Anesthesiology | 29649094 | TX |
Practice location
100 Hillcrest Medical BlvdWaco, TX 76712-8897
Phone 254-202-2000 · Fax 254-202-5849
Mailing address
Po Box 844658Dallas, TX 75284-4658
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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