MEDICARE: GERALD BUSCH M.D.P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	101YP2500X	Professional Counselor
3	2084F0202X	Forensic Psychiatry Physician
4	2084P0800X	Psychiatry Physician

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
2	F67V	OTHER	TX	BLUE CROSS BLUE SHIELD
3	10008925	OTHER	TX	AMERIGROUP

General Provider Information

NPI Number	:	1518168996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERALD BUSCH M.D.P.A.

Provider Business Mailing Address
First Line	:	6900 S RICE AVE
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4439
Country	:	US
Telephone Number	:	281-661-6904
Fax Number	:	713-665-9100

Provider Business Practice Location Address
First Line	:	6550 MAPLERIDGE ST STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4647
Country	:	US
Telephone Number	:	866-971-8423
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERALD I BUSCH
Credential	:	M.D.
Telephone Number	:	713-665-9000

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	09/13/2018

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