Individual
MICHAEL G BUSTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
360 LARCHMONT DR, SAN ANTONIO, TX 78209-4273
(210) 452-7937
Mailing address
360 LARCHMONT DR, SAN ANTONIO, TX 78209-4273
(210) 452-7937
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
36051
TX
Other
Enumeration date
04/01/2013
Last updated
04/01/2013
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