Individual
DR. MATTHEW DONALD BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN, DALLAS, TX 75230-2505
(972) 758-3598
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K7511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046632801
—
TX
01
—
88529K
BCBS
TX
01
—
930076312
MEDICARE RAILROAD
TX
Enumeration date
12/13/2005
Last updated
02/18/2010
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