Individual
MRS. AURORA BUSTILLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC-MNN, IBCLC
Contact information
Practice address
1201 S MAIN ST, FORT WORTH, TX 76104-4804
(817) 702-7524
(817) 920-6596
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-7524
(817) 920-6596
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
578013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10920319
IBLCE
TX
01
—
578013
BOARD OF NURSE EXAMINERS
TX
01
—
BUS1-0429-7211
NCC
TX
Enumeration date
06/10/2011
Last updated
10/23/2014
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