Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 12286 | TX |
NPI | 1093056095 |
---|---|
Provider Name | Dr. Andrew Emile Buller |
First Address | San Antonio, TX 78232-5052 |
Second Address | Sugar Land, TX 77479-2375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2013 |
Last Update Date | 13/08/2013 |