Provider Demographics
NPI:1518168996
Name:GERALD BUSCH M.D.P.A.
Entity Type:Organization
Organization Name:GERALD BUSCH M.D.P.A.
Other - Org Name:PACE MENTAL HEALTH HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:I
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-665-9000
Mailing Address - Street 1:6900 S RICE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4439
Mailing Address - Country:US
Mailing Address - Phone:281-661-6904
Mailing Address - Fax:713-665-9100
Practice Address - Street 1:6550 MAPLERIDGE ST STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4647
Practice Address - Country:US
Practice Address - Phone:866-971-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316226-01Medicaid
TXF67VOtherBLUE CROSS BLUE SHIELD
TX10008925OtherAMERIGROUP
TX1316226-01Medicaid
TXTXB119061Medicare PIN