Provider Demographics
NPI:1023049277
Name:BUCHERT, GERALD R (PA)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:R
Last Name:BUCHERT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 WEST LOOP S STE 2100
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2117
Mailing Address - Country:US
Mailing Address - Phone:713-486-0910
Mailing Address - Fax:
Practice Address - Street 1:5420 WEST LOOP S STE 2100
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2117
Practice Address - Country:US
Practice Address - Phone:713-486-0910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03481363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N8618OtherBCBS
TX187248301Medicaid
TX187248305Medicaid
TXP70997Medicare UPIN
TXP00294538Medicare PIN
TX8D8271Medicare PIN