Provider Demographics
NPI:1770677908
Name:BUSSE, MEGYN LEONOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGYN
Middle Name:LEONOR
Last Name:BUSSE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4700 SETON CENTER PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5711
Mailing Address - Country:US
Mailing Address - Phone:512-345-3595
Mailing Address - Fax:512-345-7618
Practice Address - Street 1:4700 SETON CENTER PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5711
Practice Address - Country:US
Practice Address - Phone:512-345-3595
Practice Address - Fax:512-345-7618
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2021-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH5754207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134442602Medicaid
TX80W590Medicare ID - Type Unspecified
TX134442602Medicaid