Provider Demographics
NPI:1912026485
Name:BUCHER, KEVIN DANIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DANIEL
Last Name:BUCHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 AUGUSTA BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5302
Mailing Address - Country:US
Mailing Address - Phone:972-771-7362
Mailing Address - Fax:
Practice Address - Street 1:661 JUSTIN RD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4821
Practice Address - Country:US
Practice Address - Phone:972-771-5264
Practice Address - Fax:972-771-0091
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1534101YP2500X
TX1744106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00002141LCOtherBLUE CROSS BLUE SHIELD