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NPI Code Detail

MEDICARE: ERIK JOSE BUSTAMANTE MD

MEDICARE: ERIK JOSE BUSTAMANTE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician10040299TX

General Provider Information

NPI Number : 1023302361
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIK JOSE BUSTAMANTE MD
Provider Business Mailing Address
First Line : 1213 HERMANN DR STE 770
Second Line :
City : HOUSTON
State : TX
Zip : 77004-7031
Country : US
Telephone Number : 712-528-8991
Fax Number :
Provider Business Practice Location Address
First Line : 1213 HERMANN DR STE 770
Second Line :
City : HOUSTON
State : TX
Zip : 77004-7031
Country : US
Telephone Number : 712-528-8991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 09/02/2022

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Directions to “ ERIK JOSE BUSTAMANTE MD” Practice Location

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