Individual
MARYLOU BUYSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7700 FISH POND RD, WACO, TX 76710-1031
(254) 724-2111
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
38004
MA
207SG0201X
Clinical Genetics (M.D.) Physician
N8620
TX
208000000X
Pediatrics Physician
Primary
N8620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035367
—
MA
Enumeration date
11/09/2005
Last updated
12/05/2011
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