Individual
DR. MARIO A BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
343 W HOUSTON, #406, SAN ANTONIO, TX 78205
(210) 224-7800
(210) 224-7501
Mailing address
343 W HOUSTON, #406, SAN ANTONIO, TX 78205
(210) 224-7800
(210) 224-7501
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G8027
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168353401
—
TX
Enumeration date
06/14/2006
Last updated
12/30/2011
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