NPIMap

Organization Active NPI

MJB Physician Services PLLC

  • Anesthesiology Physician
  • Plano, TX
National Provider Identifier
1497200794
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MJB PHYSICIAN SERVICES PLLC
Practice address
1701 Ohio Dr
Plano, TX 75093-5208
Phone
(972) 502-9981
NPI assigned
Aug 17, 2016
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Phillip Boostrom
Title
Registered Agent
Phone
(972) 502-9981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1701 Ohio Dr
Plano, TX 75093-5208

Mailing address

PO Box 999
Prosper, TX 75078-4416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170525000788 TX Part B Supplier - Clinic/Group Practice 3971870890 Receives reassigned benefits from 8 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1497200794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 999",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750784416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 OHIO DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935208",
            "telephone_number": "972-502-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJB PHYSICIAN SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "BOOSTROM",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "972-502-9981"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.