Provider Demographics
NPI:1568788511
Name:OSVALDO A BRUSCO MD PA
Entity Type:Organization
Organization Name:OSVALDO A BRUSCO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUSCO
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:361-813-0684
Mailing Address - Street 1:5814 ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4173
Mailing Address - Country:US
Mailing Address - Phone:361-813-0684
Mailing Address - Fax:361-879-0982
Practice Address - Street 1:5814 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4173
Practice Address - Country:US
Practice Address - Phone:361-813-0684
Practice Address - Fax:361-879-0982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1785207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty