Individual provider Active NPI

Bo S Husberg, M.D.

  • Surgery Physician
  • Dallas, TX
National Provider Identifier
1174599146
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G8541 Issued in TX
Practice address
221 W Colorado Blvd
Pav II Ste # 535
Dallas, TX 75208-2363
Phone
(214) 947-4400
Fax
(214) 947-4404
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G8541 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd
Pav II Ste # 535
Dallas, TX 75208-2363

Mailing address

3400 W Wheatland Rd
Pav III Ste#260
Dallas, TX 75237-4418
Phone (214) 947-7325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Pulmonary & Critical Care PA Past Accepting new patients
Methodist Transplant Physicians PastSince Jul 15, 2007 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174599146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W WHEATLAND RD",
            "address_2": "PAV III STE#260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752374418",
            "telephone_number": "214-947-7325",
            "fax_number": "214-947-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD",
            "address_2": "PAV II STE # 535",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082363",
            "telephone_number": "214-947-4400",
            "fax_number": "214-947-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSBERG",
        "first_name": "BO",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G8541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.