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Individual
DR. MICKEY VERNELL BUSH
Active
Individual
DR. MICKEY VERNELL BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F3800
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780678698
BLUE CROSS BLUE SHIELD
TX
01
—
P00936712
MEDICARE RR
TX
01
—
P00941074
MEDICARE RR
TX
Enumeration date
09/07/2005
Last updated
08/16/2022
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