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General NPI Number Information
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NPI Number | 1679491377
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Entity Type | Individual
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Provider Name | NICHOLAS JAMES BUSTAMENTO ATP
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Gender | Male
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 2111 FM 1960 RD E
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City | HUMBLE
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State | TX
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Zip | 77338-5229
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Country | US
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Telephone | 832-392-9946
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Fax |
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Provider Business Mailing Address
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Address Line | 16918 SOLOMONS PLUME LN
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City | CYPRESS
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State | TX
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Zip | 77429-1681
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Country | US
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Telephone | 832-392-9946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State | TX
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