Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | M1548 | TX |
NPI | 1033171228 |
---|---|
Provider Name | Dr. David Michael Bush |
First Address | San Antonio, TX 78258-7742 |
Second Address | Lackland A F B, TX 78236-9907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 08/07/2007 |