Provider Demographics
NPI:1477636132
Name:SOARES, BOSCO FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:BOSCO
Middle Name:FRANCISCO
Last Name:SOARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11406 DORRANCE LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1806
Mailing Address - Country:US
Mailing Address - Phone:206-853-3895
Mailing Address - Fax:
Practice Address - Street 1:1401 FOUCHER ST
Practice Address - Street 2:STE M1005
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3515
Practice Address - Country:US
Practice Address - Phone:504-897-8948
Practice Address - Fax:504-897-7145
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200294208100000X, 2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Not Answered2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine