=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871984807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NORMA ALEJANDRA BUENO MARTINEZ M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2015
-----------------------------------------------------
Last Update Date | 10/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 561 W MEDICAL CENTER BLVD STE A
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-486-1590
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 561 W MEDICAL CENTER BLVD STE A
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-486-1590
-----------------------------------------------------
Fax | 713-486-1594
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0202X
-----------------------------------------------------
Taxonomy Name | Pediatric Cardiology Physician
-----------------------------------------------------
License Number | T6199
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------