Provider Demographics
NPI:1851652770
Name:BOULOS, SCARLETT (MD)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:
Last Name:BOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6700 WEST LOOP SOUTH
Mailing Address - Street 2:SUITE #500
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-791-9966
Mailing Address - Fax:713-791-9966
Practice Address - Street 1:6700 WEST LOOP SOUTH
Practice Address - Street 2:SUITE #500
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-791-9966
Practice Address - Fax:713-791-9966
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA252075207R00000X
PAMD457211207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine