Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 11254 | TX |
NPI | 1043339633 |
---|---|
Provider Name | Dr. Robert Lawson Buckles |
First Address | Plano, TX 75093-5803 |
Second Address | Plano, TX 75093-5803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0034116 | HARRIS METHODIST (01) | TX |
0735300 | AETNA HMO (01) | TX |
188533 | UNITED CONCORDIA (01) | TX |
4248067 | AETNA PPO (01) | TX |
4549321004 | CIGNA (01) | TX |
8112445 | BLUE LINK (01) | TX |
FB73 | BLUE CROSS BLUE SHIELD (01) | TX |
T12445 | (02) | TX |
TX1392 | AETNA DMO (01) | TX |