Provider Demographics
NPI:1730289158
Name:BUSKIRK, KATHRYN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:BUSKIRK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682527
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268-2527
Mailing Address - Country:US
Mailing Address - Phone:281-583-7766
Mailing Address - Fax:281-583-8991
Practice Address - Street 1:20203 CYPRESSWOOD GLEN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373
Practice Address - Country:US
Practice Address - Phone:281-583-7766
Practice Address - Fax:281-583-8991
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2101174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX06930KMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #
TXF37149Medicare UPIN