Provider Demographics
NPI:1023129525
Name:BUISSERETH, ALBERT
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:BUISSERETH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14414 228TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3655
Mailing Address - Country:US
Mailing Address - Phone:956-292-4359
Mailing Address - Fax:
Practice Address - Street 1:6225 FM 2920 RD STE 204
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3401
Practice Address - Country:US
Practice Address - Phone:281-378-4707
Practice Address - Fax:281-378-4709
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX646072279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care