Provider Demographics
NPI:1710112503
Name:RONALD R BUESCHER MD PA
Entity Type:Organization
Organization Name:RONALD R BUESCHER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-667-9100
Mailing Address - Street 1:10021 S MAIN ST
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5224
Mailing Address - Country:US
Mailing Address - Phone:713-667-9100
Mailing Address - Fax:713-668-5455
Practice Address - Street 1:10021 S MAIN ST
Practice Address - Street 2:SUITE B-4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5224
Practice Address - Country:US
Practice Address - Phone:713-667-9100
Practice Address - Fax:713-668-5455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6488261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care