Provider Demographics
NPI:1114933017
Name:BUCHANAN, STEVE P (DO)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:P
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99335
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 MONTGOMERY ST
Practice Address - Street 2:DEPT OF OB/GYN
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2553
Practice Address - Country:US
Practice Address - Phone:817-927-1065
Practice Address - Fax:817-927-1162
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX847062OtherBCBS
TX104209503Medicaid
TX160016278OtherRAILROAD MEDICARE
TX160016278OtherRAILROAD MEDICARE
TXD75104Medicare UPIN