Individual
MARK BRIAN BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
913 COTTONWOOD DR, SHERMAN, TX 75090-2831
(903) 868-9565
(903) 893-8916
Mailing address
332 KLAS RD, SHERMAN, TX 75092-5959
(903) 813-0521
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J1898
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123463507
—
TX
05
—
123463508
—
TX
05
—
123463509
—
TX
05
—
123463510
—
TX
05
—
123463511
—
TX
05
—
752684562
—
TX
01
—
8W0344
BCBS
TX
01
—
8W0739
BCBS
TX
Enumeration date
08/01/2006
Last updated
03/06/2012
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