MEDICARE: DR. GEOFFREY HARRY BUNCKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	23806	OR
2	2086S0122X	Plastic and Reconstructive Surgery Physician	23806	OR

General Provider Information

NPI Number	:	1295863520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEOFFREY HARRY BUNCKE M.D.

Provider Business Mailing Address
First Line	:	94 BRIGGS ST STE 600
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1272
Country	:	US
Telephone Number	:	201-872-3668
Fax Number	:	210-428-6317

Provider Business Practice Location Address
First Line	:	94 BRIGGS ST STE 600
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1272
Country	:	US
Telephone Number	:	201-872-3668
Fax Number	:	210-428-6317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	06/27/2024

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