Provider Demographics
NPI:1760585194
Name:BUZZARD, AARON KEITH (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:KEITH
Last Name:BUZZARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10485 S FM 2038
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77808
Mailing Address - Country:US
Mailing Address - Phone:210-380-6017
Mailing Address - Fax:
Practice Address - Street 1:10485 S FM 2038
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77808
Practice Address - Country:US
Practice Address - Phone:210-380-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239139207P00000X
TXM9896207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L0866Medicare PIN
TX8L0868Medicare PIN
TX8L0869Medicare PIN
TX8L0867Medicare PIN