Boughton, Linda K

Boughton, Linda K is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Boughton, Linda K can be contacted via phone (817) 921-3431.

Contact Information

Primary practice address
1500 S Main St Fort Worth TX 76104-4917
Phone: (817) 921-3431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 571139 Texas

Profile Details

NPI number 1699701649
LBN Legal business name Boughton, Linda K
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Oct 30th, 2012 - about 14 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 1699701649 NPPES
Texas MEDICAID 044387103

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