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General NPI Number Information
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NPI Number | 1851731921
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Entity Type | Individual
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Provider Name | MICHAEL S BUSBY M.ED., LAT, ACT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 110 SANDPIPER CV
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City | AUSTIN
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State | TX
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Zip | 78737-4742
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Country | US
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Telephone | 903-746-7182
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Fax |
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Provider Business Mailing Address
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Address Line | 2965 CAPE COD CIR
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City | CARLSBAD
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State | CA
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Zip | 92010-6548
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Country | US
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Telephone | 903-746-7182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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