Provider Demographics
NPI:1992082663
Name:BUSSE, JULIA DIANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:DIANA
Last Name:BUSSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:DIANA
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1002 DIXIELAND RD
Mailing Address - Street 2:T-0802
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-5913
Mailing Address - Country:US
Mailing Address - Phone:956-440-8329
Mailing Address - Fax:956-440-8329
Practice Address - Street 1:1002 DIXIELAND RD
Practice Address - Street 2:T-0802
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-5913
Practice Address - Country:US
Practice Address - Phone:956-440-8329
Practice Address - Fax:956-440-8329
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist