Individual provider Active NPI

Joelle M Bouldoukian-Choucair, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1689623894
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6180T Issued in TX
Practice address
300 W Bitters Rd Ste 130
San Antonio, TX 78216-1690
Phone
(210) 399-3675
Fax
(210) 598-9235
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6180T TX Primary

Addresses

Primary practice location

300 W Bitters Rd Ste 130
San Antonio, TX 78216-1690

Mailing address

300 W Bitters Rd Ste 130
San Antonio, TX 78216-1690
Phone (210) 399-3675

Other identifiers 1

IdentifierTypeStateIssuer
0063FDOtherTXBCBS

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

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1689623894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W BITTERS RD STE 130",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161690",
            "telephone_number": "210-399-3675",
            "fax_number": "210-598-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BITTERS RD STE 130",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161690",
            "telephone_number": "210-399-3675",
            "fax_number": "210-598-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULDOUKIAN-CHOUCAIR",
        "first_name": "JOELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6180T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0063FD",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.