| Doctor Name: | BLAINE ERIC BOOHER |
| NPI Number: | 1013221373 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 1191290 |
| Business Practice Address: | 16020 Park Valley Dr Round Rock, TX - 786813573 |
| Business Phone Number: | 5123881448 |
| Business Fax Number: | 5123887854 |
| Mailing Address: | 16020 Park Valley Dr, ROUND ROCK |
| State: | TX |
| Postal Code: | 786813573 |
| Phone Number: | 5123881448 |
| Fax Number: | 5123887854 |
| NPI Enumeration Date: | 07/28/2010 |
| NPI Last Update Date: | 07/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 1191290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |