Provider Demographics
NPI:1588656961
Name:BUCK, ERNEST D (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:D
Last Name:BUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:425 DOLPHIN PL
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1513
Mailing Address - Country:US
Mailing Address - Phone:361-853-3222
Mailing Address - Fax:361-561-2692
Practice Address - Street 1:3533 S ALAMEDA ST
Practice Address - Street 2:#303 JOSEPH M. SLOAN BLDG.
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-853-3222
Practice Address - Fax:361-561-2692
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81W695Medicare ID - Type Unspecified
TXC13905Medicare UPIN