Individual
DR. PEDRO MANUEL BUSTAMANTE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 CALIFORNIA ST, HOUSTON, TX 77006
(832) 548-5000
(713) 523-4897
Mailing address
PO BOX 66308, HOUSTON, TX 77266
(832) 548-5076
(713) 523-4897
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
P1279
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080462703
—
TX
Enumeration date
07/18/2008
Last updated
08/20/2018
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