Organization Active NPI

John M. Bouras, MD, PA

  • Psychiatry Physician
  • Victoria, TX
National Provider Identifier
1629251012
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M5069 Issued in TX
Legal business name
JOHN M. BOURAS, MD, PA
Practice address
2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775
Phone
(361) 574-1899
NPI assigned
Dec 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Bouras John
Title
President
Phone
(361) 574-1899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X M5069 TX Primary

Addresses

Primary practice location

2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775

Mailing address

2705 Hospital Dr
Ste 206
Victoria, TX 77901-5775
Phone (361) 574-1899

National Provider Directory

National Provider Directory

Locations

2710 Hospital Dr
Ste 206
Victoria, TX 77901
Phone (361) 574-1899

2705 Hospital Dr
Ste 206
Victoria, TX 77901
Phone (361) 574-1899

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1629251012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE 206",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "STE 206",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. BOURAS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-09",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "BOURAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-574-1899"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M5069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.