Provider Demographics
NPI:1922122886
Name:BUCHE, WILLIAM AUBREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AUBREY
Last Name:BUCHE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6975
Mailing Address - Country:US
Mailing Address - Phone:235-949-1288
Mailing Address - Fax:325-223-9551
Practice Address - Street 1:3015 GREEN MEADOW DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6975
Practice Address - Country:US
Practice Address - Phone:235-949-1288
Practice Address - Fax:325-223-9551
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127111223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD000421E2Medicaid
TXT12442Medicare UPIN
TXD000421E2Medicaid