Individual provider · NPI-1

Caleb James Boutte

Health Educator · Houston, TX

NPI number1609424290
StatusActive
Last updated in NPPESAug 28, 2019

Details

NPI
1609424290
Entity type
Individual (NPI-1)
Name
Caleb James Boutte
Sex
Male
Sole proprietor
No
Enumeration date
Aug 28, 2019
Last updated
Aug 28, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174H00000X Health Educator––Yes

Practice location

3611 Ennis St
Houston, TX 77004-4407

Phone 832-393-4055 · Fax 832-393-4088

Mailing address

3611 Ennis St
Houston, TX 77004-4407

Phone 832-393-4055 · Fax 832-393-4088

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