JOHN KELLY BOUDREAUX


Address: 1301 Pennsylvania Ave, Srp2-room 73, Fort Worth, TX 76401
Phone: 9727155000

JOHN KELLY BOUDREAUX (NPI# 1356381651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356381651
Entity Type Individual
Full Name JOHN KELLY BOUDREAUX
Credential MD
Practice Address 1301 Pennsylvania Ave
Srp2-room 73
Fort Worth
TX 76401
Mailing Address Po Box 840853
Dallas
TX 75284-0853
Practice Telephone 9727155000
Practice Fax Number 9727159976
Mailing Telephone 9727155000
Mailing Fax Number 9727159976
Enumeration Date 2006-06-07
Last Update Date 2020-04-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207L00000X Anesthesiology H9601 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX BCBS 8S7607 01
TX 098487405 05

Other Providers JOHN BOUDREAUX

NPI Name Taxonomy Address Enumeration
1871602581 John Neal Boudreaux Dentist 600 Haifleigh St, Franklin, LA 70538 2006-08-29
1407879455 John Philip Boudreaux Surgery 200 W Esplanade Ave, Suite 200, Kenner, LA 70065-2489 2006-07-25
1730116617 John Daniel Boudreaux Physical Therapist 816 Harding St, Lafayette, LA 70503-2320 2006-06-27

Office Location

Street Address 1301 PENNSYLVANIA AVE
SRP2-ROOM 73
City FORT WORTH
State TX
Zip Code 76401

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144227257 Robert Louis Quillin Pediatrics 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2005-07-05
1003414996 Jana Mitchell Registered Nurse 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-10-13
1730799941 Brin Alexandra Morris Registered Nurse 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-08-03
1871103168 Niki Sheth Registered Nurse 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-08-03
1033736863 Molly Taylor Respiratory Therapist, Registered 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-06-27
1215554175 Suja Varghese Nurse Practitioner 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-06-26
1538786470 Amanda A Viehmann Registered Nurse 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-06-26
1376169599 Heather Nicole Le Nurse Practitioner 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-06-23
1750904249 Kelli Renee Vogler Physician Assistant 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-05-19
1598387169 Alim Virji Radiology 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 2020-05-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1700421930 Catherine Johns Speech-Language Pathologist 418 County Road 428, # 418, Stephenville, TX 76401 2019-11-12
1457828683 Allison Ann Luedeker Nurse Practitioner 950 Bluebonnet Street, Stephenville, TX 76401 2018-10-25
1326528092 Stephanie Renee Drake Speech-Language Pathologist 1739 Bull Elk Dr, Stephenville, TX 76401 2018-08-21
1528564804 Dylan D Dawson Specialist/Technologist 1590 Washington St, Stephenville, TX 76401 2018-04-04
1730680117 Alison Lea Reynolds Licensed Vocational Nurse 208 Prairie Wind, Stephenville, TX 76401 2018-02-22
1760855977 Gina Neri Physical Therapy Assistant 1670 West Lingley Rd, Stephenville, TX 76401 2015-11-10
1104216886 Edmund Case Horton Rehabilitation Counselor 2443-8 Nw Loop, Stephenville, TX 76401 2015-02-02
1043648215 Cross Timbers Imaging Radiology 561 N. Graham St, Stephenville, TX 76401 2013-10-24
1306273362 Kelley Camille Verpooten Counselor 239 S. Virginia Street, Stephenville, TX 76401 2013-10-04
1477735140 Nanette V Evans M.d., P.a. Radiology 150 Rivernorth Blvd., Stephenville, TX 76401 2007-12-04
Find all providers in zip 76401

Taxonomy Information

Taxonomy Code 207L00000X
Grouping Allopathic & Osteopathic Physicians
Classification Anesthesiology

Taxonomy Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104440411 Valor Interventional Pain, LLC Anesthesiology 6620 Bryant Irvin Rd Ste 100, Fort Worth, TX 76132-4224 2020-06-02
1588146799 Vertex Advanced Pain Management and Spine Specialist Pllc Anesthesiology 1325 Pennsylvania Ave Ste 300, Fort Worth, TX 76104-2110 2018-09-04
1427555077 Globus Anesthesia, Pllc Anesthesiology 8901 Tehama Ridge Pkwy Ste 127244, Fort Worth, TX 76177-2031 2018-04-10
1932611654 Trinity Medical Associates, Pllc. Anesthesiology 3023 South University Drive, Suite 135, Fort Worth, TX 76109-5608 2017-11-03
1376090688 U S Anesthesia Partners of Texas, Pa Anesthesiology 4444 Heritage Trace Pkwy Ste 408, Fort Worth, TX 76244 2016-09-02
1770944076 Ctpc Fort Worth, Pllc Anesthesiology 72356 Boat Club Road, Fort Worth, TX 76179-4555 2016-03-14
1124402680 Metro Pain Laser Anesthesiology 6333 Airport Fwy # 102, Fort Worth, TX 76117-5323 2015-07-15
1588984439 Bryan Skulpoonkitti Anesthesiology 416 S Henderson St, Fort Worth, TX 76104-1017 2010-06-02
1386978203 Anesthesia By Ac Pa Anesthesiology 3701 Encanto Dr, Fort Worth, TX 76109-3547 2009-09-24
1215193990 Davida Denise Rixter Anesthesiology 5407 Basswood Blvd Ste 115, Fort Worth, TX 76137-4499 2008-08-01
Find all providers in FORT WORTH

Competitor

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City FORT WORTH
Zip Code 76401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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