Provider Demographics
NPI:1326213380
Name:BUSCHEMEYER, WILLIAM COOPER III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COOPER
Last Name:BUSCHEMEYER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22710 PROFESSIONAL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-6009
Mailing Address - Country:US
Mailing Address - Phone:281-685-2709
Mailing Address - Fax:281-719-5907
Practice Address - Street 1:17070 RED OAK DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2615
Practice Address - Country:US
Practice Address - Phone:281-444-7077
Practice Address - Fax:281-444-5799
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01068483A208800000X
KY43513208800000X
TXP4291208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00895254OtherRAILROAD MEDICARE
IN201028450Medicaid
INM400040566Medicare PIN
TXTXB162853Medicare PIN
KYP400034396Medicare PIN
KYP400025241Medicare PIN