Provider Demographics
NPI:1063567634
Name:BUCHINGER, JAMES BRANT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRANT
Last Name:BUCHINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:
Practice Address - Street 1:520 DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8307
Practice Address - Country:US
Practice Address - Phone:903-597-2002
Practice Address - Fax:903-525-2778
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23577207V00000X
TXQ4370207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GS833OtherBCBS
TX3654691001Medicaid
OK200027130AMedicaid
TXP01762475OtherRAIL ROAD MEDICARE
OKOKA103446Medicare PIN