Provider Demographics
NPI:1548313455
Name:BUSKEN, CHRISTOPHER JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:BUSKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12501 JUDSON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4117
Mailing Address - Country:US
Mailing Address - Phone:210-369-9151
Mailing Address - Fax:210-616-2293
Practice Address - Street 1:12501 JUDSON RD STE 201
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-4117
Practice Address - Country:US
Practice Address - Phone:210-369-9151
Practice Address - Fax:210-616-2293
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2020-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA001927208600000X
TXP51602086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I773604Medicare PIN