Individual
EDWARD D BUCKINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2745 BEE CAVES ROAD, SUITE 101, AUSTIN, TX 78746
(512) 401-2500
(512) 401-2501
Mailing address
PO BOX 128, AUSTIN, TX 78767-0128
(512) 401-2500
(512) 401-2501
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
K5468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144634100
FIRST CARE
—
05
—
163600302
—
TX
01
—
276816
AMERIGROUP
—
01
—
8V2550
BCBS
TX
Enumeration date
11/17/2005
Last updated
11/06/2013
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