Active NPI
Emeric Boudreaux, D.D.S.
- Dentist
- Houston, TX
National Provider Identifier
1356718043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6552
- Practice address
- 7500 Cambridge St Ste 6150
Houston, TX 77054-2032 - Phone
- (713) 486-4052
- NPI assigned
- Aug 28, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6552 | LA | Primary |
Addresses
Primary practice location
7500 Cambridge St Ste 6150
Houston, TX 77054-2032
Mailing address
7500 Cambridge St Ste 6150
Houston, TX 77054-2032
Phone (713) 486-4052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356718043 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230823003806 | LA | Order and Referring Only - Maxillofacial Surgery | 6103289111 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1356718043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 CAMBRIDGE ST STE 6150",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770542032",
"telephone_number": "713-486-4052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 CAMBRIDGE ST STE 6150",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770542032",
"telephone_number": "713-486-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "EMERIC",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-28",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6552",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356718043",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.