Provider Demographics
NPI:1174599146
Name:HUSBERG, BO S (MD)
Entity type:Individual
Prefix:
First Name:BO
Middle Name:S
Last Name:HUSBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 W WHEATLAND RD
Mailing Address - Street 2:PAV III STE#260
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4418
Mailing Address - Country:US
Mailing Address - Phone:214-947-7325
Mailing Address - Fax:214-947-7349
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAV II STE # 535
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-947-4400
Practice Address - Fax:214-947-4404
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXG8541208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery