Individual
MARCO ANTONIO BUSTAMANTE BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 W HAGUE RD, STE 590, EL PASO, TX 79902-5808
(915) 532-1620
(915) 544-3852
Mailing address
125 W HAGUE RD, STE 590, EL PASO, TX 79902-5808
(915) 532-1620
(915) 544-3852
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R4017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382214002
—
TX
Enumeration date
05/21/2014
Last updated
07/08/2020
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