Konstantinos Boukas, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

P9165 Issued in TX

Practice address

6431 Fannin Street
MSB 3.160
Houston, TX 77030

Phone

(713) 500-5652

Fax

(713) 486-0989

NPI assigned

Jun 1, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Pediatrics

  Medicare reassignment NPD
• Ut Physicians

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1982666111
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1174725253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN STREET",
            "address_2": "MSB 3.160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-5652",
            "fax_number": "713-486-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN STREET",
            "address_2": "MSB 3.160",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-5652",
            "fax_number": "713-486-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUKAS",
        "first_name": "KONSTANTINOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P9165",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 101777",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME 101777",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "P9165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita M Bouges, MSW
• Philip Boughton, CRNA
• Marcy Lea Bouillion, APRN, FNP
• Charbel Antoine Boujaoude, RPH
• Jamila Sara-Anne Berkegui Boukari
• Sarkis Garo Bouladian, SOON WILL HAVE MD
• Luay Boulahouache
• Jessica Lynn Boulavsky, MD
• Elijah Bouldin, MS, ATC, LAT
• Tammy Shanae Bouldin, E.M.T

• Pediatric Critical Care Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Critical Care Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.