Individual
HANZY F. BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 MEDICAL PKWY, BLDG B., #220, CEDAR PARK, TX 78613-7763
(512) 324-4083
(512) 419-9016
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13166411-1205
UT
207R00000X
Internal Medicine Physician
22429
NV
207R00000X
Internal Medicine Physician
Primary
M1551
TX
208M00000X
Hospitalist Physician
M1551
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1759557-02
—
TX
05
—
175955701
—
TX
05
—
175955703
—
TX
05
—
175955704
—
TX
05
—
175955705
—
TX
05
—
175955706
—
TX
05
—
175955707
—
TX
Enumeration date
04/04/2006
Last updated
04/20/2023
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