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General NPI Number Information
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NPI Number | 1396966271
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Entity Type | Organization
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Legal Business Name | GUSTAVO BUENTELLO, M.D., F.A.A.P., P.A.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1220 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6420
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Country | US
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Telephone | 956-968-9571
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Fax | 956-973-0978
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Provider Business Mailing Address
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Address Line | 1220 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6420
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Country | US
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Telephone | 956-968-9571
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Fax | 956-973-0978
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUSTAVO BUENTELLO
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Credential | M.D.
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Telephone | 956-968-9571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E1821
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License Number State | TX
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