Individual
MARK H BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6116 OAKBEND TRAIL, 112, FT WORTH, TX 76132-3926
(817) 346-7800
(817) 346-7408
Mailing address
6901 RIVER PARK CIRCLE, FT WORTH, TX 76116-8465
(817) 732-0800
(817) 956-9119
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J0452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153003202
—
TX
Enumeration date
06/13/2006
Last updated
12/01/2010
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