Provider Demographics
NPI:1598961591
Name:BUSSCHER, MARK DENNIS
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:DENNIS
Last Name:BUSSCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 NASA PARKWAY
Mailing Address - Street 2:SUITE #G-1
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-3447
Mailing Address - Country:US
Mailing Address - Phone:281-326-2612
Mailing Address - Fax:281-326-2612
Practice Address - Street 1:2622 NASA PARKWAY
Practice Address - Street 2:SUITE #G-1
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-3447
Practice Address - Country:US
Practice Address - Phone:281-326-2612
Practice Address - Fax:281-326-2612
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50156237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist