MEDICARE: DR. OSCAR GARY BUKSTEIN 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	2084P0800X	Psychiatry Physician	N8170	TX
2	2084P0804X	Child & Adolescent Psychiatry Physician	N817	TX
3	2084P0802X	Addiction Psychiatry Physician	N817	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831161876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSCAR GARY BUKSTEIN M.D.

Provider Business Mailing Address
First Line	:	1941 EAST RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-6010
Country	:	US
Telephone Number	:	713-486-2611
Fax Number	:	713-486-2721

Provider Business Practice Location Address
First Line	:	1941 EAST RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-6010
Country	:	US
Telephone Number	:	713-486-2611
Fax Number	:	713-486-2721

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	05/16/2013

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