Provider Demographics
NPI:1407856362
Name:BUESCHER, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:BUESCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 EASTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-3342
Mailing Address - Country:US
Mailing Address - Phone:936-327-7147
Mailing Address - Fax:936-327-6234
Practice Address - Street 1:219 EASTWOOD ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3342
Practice Address - Country:US
Practice Address - Phone:936-327-7147
Practice Address - Fax:936-327-6234
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5550207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T36FOtherBLUECROSS BLUE SHIELD
TX00T36FOtherBLUECROSS BLUE SHIELD
TXG08734Medicare UPIN
TX00T36FMedicare PIN