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General NPI Number Information
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NPI Number | 1346757051
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Entity Type | Organization
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Legal Business Name | VASCULAR & ENDOVASCULAR SURGERY OF TEXAS, PLLC
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 12501 JUDSON RD STE 201
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City | LIVE OAK
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State | TX
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Zip | 78233-4117
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Country | US
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Telephone | 210-369-9151
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Fax | 210-616-2293
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Provider Business Mailing Address
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Address Line | 12501 JUDSON RD STE 201
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City | LIVE OAK
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State | TX
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Zip | 78233-4117
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Country | US
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Telephone | 210-369-9151
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Fax | 210-616-2293
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER J BUSKEN
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Credential | MD
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Telephone | 210-369-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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