Healthcare Provider Details

I. General information

NPI: 1023153624
Provider Name (Legal Business Name): RICHARD G BUCH MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W 15TH ST SUITE 290
PLANO TX
75093-5841
US

IV. Provider business mailing address

4001 W 15TH ST SUITE 290
PLANO TX
75093-5841
US

V. Phone/Fax

Practice location:
  • Phone: 469-443-0925
  • Fax: 469-443-0943
Mailing address:
  • Phone: 469-443-0925
  • Fax: 469-443-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberH5391
License Number StateTX

VIII. Authorized Official

Name: DR. RICHARD G BUCH
Title or Position: MD
Credential: MD
Phone: 469-443-0924