Provider Demographics
NPI:1972543502
Name:BUSCHOW, ROBERT ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:BUSCHOW
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 1:809 W RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2507
Mailing Address - Country:US
Mailing Address - Phone:817-460-0257
Mailing Address - Fax:817-548-0607
Practice Address - Street 1:809 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2507
Practice Address - Country:US
Practice Address - Phone:817-460-0257
Practice Address - Fax:817-548-0607
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110094180OtherRAILROAD MEDICARE
TX123204305Medicaid
TX123204303Medicaid
TX80X114Medicare PIN
TXC13992Medicare UPIN