Provider Demographics
NPI:1588784367
Name:BUSBY, JAMES G (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:BUSBY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 BORDEN CIR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-6218
Mailing Address - Country:US
Mailing Address - Phone:361-443-8302
Mailing Address - Fax:
Practice Address - Street 1:5406 BORDEN CIR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-6218
Practice Address - Country:US
Practice Address - Phone:361-443-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2396152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist