Provider Demographics
NPI:1255335279
Name:BUQUING, JOEY OLIVER (MD)
Entity type:Individual
Prefix:
First Name:JOEY
Middle Name:OLIVER
Last Name:BUQUING
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 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4803
Mailing Address - Country:US
Mailing Address - Phone:713-795-5511
Mailing Address - Fax:832-553-6081
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4803
Practice Address - Country:US
Practice Address - Phone:713-795-5511
Practice Address - Fax:832-553-6081
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1787207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119046401Medicaid
AMERIGROUP 52499OtherAMERIGROUP
BCBS 81091XOtherBCBS
AMERIGROUP 52499OtherAMERIGROUP
F95229Medicare UPIN