Active NPI
Maryam Boushehri
- Chiropractor
- Leander, TX
National Provider Identifier
1205061058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11817
- Practice address
- 1640 Highland Falls Dr Ste 701
Leander, TX 78641-4842 - Phone
- (512) 774-0174
- NPI assigned
- May 22, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 11817 | TX | Primary |
Addresses
Primary practice location
1640 Highland Falls Dr Ste 701
Leander, TX 78641-4842
Mailing address
PO Box 894
Cedar Park, TX 78630-0894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11817 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1205061058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 894",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786300894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 HIGHLAND FALLS DR STE 701",
"city": "LEANDER",
"state": "TX",
"postal_code": "786414842",
"telephone_number": "512-774-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUSHEHRI",
"first_name": "MARYAM",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-22",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "11817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leander, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.