Individual
DANIEL BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4815 ALAMEDA AVE, EL PASO, TX 79905-7990
(915) 215-4956
Mailing address
440 RAYNOLDS ST., MSC51015, EL PASO, TX 79905-2709
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Q7658
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD2014-0816
NM
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
Q7658
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2011
Last updated
11/05/2019
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