Provider Demographics
NPI:1083028625
Name:JBUZ, LLC
Entity Type:Organization
Organization Name:JBUZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:BUZBEE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:817-706-2778
Mailing Address - Street 1:1622 TAMARRON CT
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4348
Mailing Address - Country:US
Mailing Address - Phone:817-706-2778
Mailing Address - Fax:
Practice Address - Street 1:1622 TAMARRON CT
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-4348
Practice Address - Country:US
Practice Address - Phone:817-706-2778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02891363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty