Provider Demographics
NPI:1437133949
Name:BOONE, JANET E (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:E
Last Name:BOONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1470
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-1470
Mailing Address - Country:US
Mailing Address - Phone:830-773-8917
Mailing Address - Fax:830-773-1892
Practice Address - Street 1:4018 EL INDIO HWY
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6690
Practice Address - Country:US
Practice Address - Phone:830-872-3460
Practice Address - Fax:830-872-3470
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6475208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1191256-20Medicaid
TX8U7230OtherBLUE CROSS BLUE SHIELD
TX119125613Medicaid
TX472004YQEUOtherMEDICARE-PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
TX119125610Medicaid
TX119125614Medicaid
TX1191256-20Medicaid
TX119125609Medicaid
TX119125615Medicaid
TX119125616Medicaid
TX1191256-19OtherMEDICAID-TX PROVIDER IDENTIFIER # (TPI) ) (AS PERFORMING PROVIDER)
TX119125612Medicaid
TX119125608Medicaid
TX119125616Medicaid
TX472004YQEUOtherMEDICARE-PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
TX119125608Medicaid