Provider Demographics
NPI:1871552059
Name:BUCK, STEVE RANDALL (DO)
Entity type:Individual
Prefix:MR
First Name:STEVE
Middle Name:RANDALL
Last Name:BUCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 COUNTRY CLB
Mailing Address - Street 2:
Mailing Address - City:LAGUNA VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78578-2922
Mailing Address - Country:US
Mailing Address - Phone:972-825-6500
Mailing Address - Fax:
Practice Address - Street 1:2601 VETERANS DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8942
Practice Address - Country:US
Practice Address - Phone:956-291-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5260208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD07564OtherMEDICARE RR PALMETTO
TX160195703Medicaid
TXDQ5280OtherMEDICARE RR PALMETTO
TXP00947794OtherPALMETTO RR
TX1601957Medicaid
IN200401550Medicaid
000000371057OtherBLUE CROSS
H84327Medicare UPIN
IN231420HHMedicare ID - Type Unspecified
TXD07564OtherMEDICARE RR PALMETTO
TXH84327Medicare UPIN
TXDQ5280OtherMEDICARE RR PALMETTO
TX00X102Medicare UPIN