Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | H4878 | TX |
N | 2081P2900X | Pain Medicine | H4878 | TX |
NPI | 1396747473 |
---|---|
Provider Name | Brian C. Buck |
First Address | Austin, TX 78716-0940 |
Second Address | Austin, TX 78746-6493 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 12/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134872410 | (05) | TX |
C13907 | (02) | TX |