=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215599410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TULIO ARNALDO BUESO AGUILAR MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2019
-----------------------------------------------------
Last Update Date | 06/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3506 21ST ST STE 400
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79410-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-725-4115
-----------------------------------------------------
Fax | 806-723-7007
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2215 NASHVILLE AVE
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79410-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-725-5228
-----------------------------------------------------
Fax | 806-723-6532
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0600X
-----------------------------------------------------
Taxonomy Name | Clinical Neurophysiology Physician
-----------------------------------------------------
License Number | V0355
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | V0355
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------