Provider Demographics
NPI:1225021751
Name:BOST, JAMES EDGAR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDGAR
Last Name:BOST
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 1:7703 FLOYD CURL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-257-1400
Mailing Address - Fax:210-257-1428
Practice Address - Street 1:7703 FLOYD CURL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-257-1400
Practice Address - Fax:210-257-1428
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1337207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116678706Medicaid
TX116678704Medicaid
TX116678705OtherCSN
TX116678706Medicaid
TX8J7180Medicare PIN
TX8K7443Medicare PIN