MEDICARE: SPECIALTY ANESTHESIA PARTNERS, PLLC

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
1	1223D0004X	Dental Anesthesiology

General Provider Information

NPI Number	:	1659177434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY ANESTHESIA PARTNERS, PLLC

Provider Business Mailing Address
First Line	:	25722 KINGSLAND BLVD STE 103D
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-2641
Country	:	US
Telephone Number	:	346-558-5881
Fax Number	:

Provider Business Practice Location Address
First Line	:	8545 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-5055
Country	:	US
Telephone Number	:	713-944-7700
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. ROBERT A BUSTO
Credential	:	DMD
Telephone Number	:	346-558-5881

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/05/2026

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