Provider Demographics
NPI:1235363862
Name:ALLAIRE, BO J (MD)
Entity Type:Individual
Prefix:DR
First Name:BO
Middle Name:J
Last Name:ALLAIRE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:STE 525
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-661-7888
Mailing Address - Fax:713-661-7899
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:STE 525
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-661-7888
Practice Address - Fax:713-661-7899
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2024-04-24
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Provider Licenses
StateLicense IDTaxonomies
TXP1515207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347801801Medicaid
TXTXB153602Medicare PIN