Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 9189 | TX |
Y | 204E00000X | Oral & Maxillofacial Surgeon | F5162 | TX |
NPI | 1023185261 |
---|---|
Provider Name | William L Buchanan |
First Address | Taylor, TX 76574-0979 |
Second Address | Austin, TX 78749-1980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 14/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B27864 | (02) | TX |