Provider Demographics
NPI:1841288099
Name:BUSCEMI, DOLORES (MD)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:BUSCEMI
Suffix:
Gender:F
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:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-9410
Practice Address - Country:US
Practice Address - Phone:806-743-3150
Practice Address - Fax:806-743-3148
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100204050AMedicaid
TX109605101Medicaid
TX86E871OtherBLUE CROSS/BLUE SHIELD
NMW0205Medicaid
TX80734ZOtherHMO BLUE
TX109605100OtherFIRSTCARE COMMERCIAL
TX131875003Medicaid
TXA070OtherTRIWEST
NM86429OtherPRESBYTERIAN COMMERCIAL
NM86429Medicaid
TX131875004Medicaid
TX80734ZOtherHMO BLUE
TXF75345TMedicare UPIN
OK100204050AMedicaid