Provider Demographics
NPI:1013007939
Name:XUAN, BO (MD)
Entity Type:Individual
Prefix:DR
First Name:BO
Middle Name:
Last Name:XUAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:A P BEUTEL HEALTH CENTER
Mailing Address - Street 2:TEXAS A&M UNIVERSITY
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843-1264
Mailing Address - Country:US
Mailing Address - Phone:979-458-8269
Mailing Address - Fax:979-458-8352
Practice Address - Street 1:A P BEUTEL HEALTH CENTER
Practice Address - Street 2:TEXAS A&M UNIVERSITY
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-1264
Practice Address - Country:US
Practice Address - Phone:979-458-8269
Practice Address - Fax:979-458-8352
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM5982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J8761Medicare PIN