Organization
JOSE D BUENO, M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE DOMIL BUENO M.D. (PRESIDENT)
(432) 580-4170
Entity
Organization
Contact information
Practice address
808 TOWER DR, SUITE 1, ODESSA, TX 79761-4239
(432) 580-4180
(432) 580-4091
Mailing address
808 TOWER DR, SUITE 1, ODESSA, TX 79761-4239
(432) 580-4180
(432) 580-4091
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J9635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110667601
—
TX
05
—
110667603
—
TX
Enumeration date
04/10/2007
Last updated
06/27/2008
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