Individual
GERARDO BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1700 E VILLA MARIA RD, BRYAN, TX 77802-2534
(979) 255-4755
Mailing address
10450 LAKEFRONT DR, COLLEGE STATION, TX 77845-3076
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15683
TX
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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