Provider Demographics
NPI:1396340691
Name:BOROS ENTERPRISES, PLLC
Entity type:Organization
Organization Name:BOROS ENTERPRISES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT-S
Authorized Official - Phone:254-394-8212
Mailing Address - Street 1:2511 TRIMMER RD STE 140 PB 138
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542
Mailing Address - Country:US
Mailing Address - Phone:254-394-8212
Mailing Address - Fax:
Practice Address - Street 1:2511 TRIMMIER RD STE 140
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1910
Practice Address - Country:US
Practice Address - Phone:254-394-8212
Practice Address - Fax:254-892-4798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3458OtherDEPARTMENT OF HEALTH MARRIAGE AND FAMILY THERAPY
TX203704OtherTEXAS STATE BOARD OF EXAMINERS OF MARRIAGE AND FAMILY THERAPISTS