Jacob Boudreaux, COTA

NPI 1750648713 · on the registry since 2012

Practice

Address: 402 S John Redditt Dr
Lufkin, TX 75904
Phone: (936) 632-2107
Fax: (936) 632-2108
Organisation at this address: Harbor Hospice 26, Lp
Angelina Rehabilitation Center, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 24

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-04-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas