Provider Demographics
NPI:1689616286
Name:SLUSHER, BYRON CRAIG X (PA)
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:CRAIG
Last Name:SLUSHER
Suffix:X
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1320 WONDER WORLD DR
Mailing Address - Street 2:101
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7557
Mailing Address - Country:US
Mailing Address - Phone:512-396-3911
Mailing Address - Fax:512-353-0807
Practice Address - Street 1:1320 WONDER WORLD DR
Practice Address - Street 2:101
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7557
Practice Address - Country:US
Practice Address - Phone:512-396-3911
Practice Address - Fax:512-353-0807
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00388363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83N752Medicare ID - Type Unspecified
TX83N752Medicare PIN