Healthcare Provider Details

I. General information

NPI: 1972543502
Provider Name (Legal Business Name): ROBERT ALEXANDER BUSCHOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W RANDOL MILL RD
ARLINGTON TX
76012-2507
US

IV. Provider business mailing address

809 W RANDOL MILL RD
ARLINGTON TX
76012-2507
US

V. Phone/Fax

Practice location:
  • Phone: 817-460-0257
  • Fax: 817-548-0607
Mailing address:
  • Phone: 817-460-0257
  • Fax: 817-548-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF3799
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: