Provider Demographics
NPI:1295863520
Name:BUNCKE, GEOFFREY HARRY (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:HARRY
Last Name:BUNCKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:94 BRIGGS ST STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1272
Mailing Address - Country:US
Mailing Address - Phone:201-872-3668
Mailing Address - Fax:210-428-6317
Practice Address - Street 1:94 BRIGGS ST STE 600
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1272
Practice Address - Country:US
Practice Address - Phone:201-872-3668
Practice Address - Fax:210-428-6317
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR238062082S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR23806OtherSTATE LICENSE
OR23806OtherSTATE LICENSE