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NPI Code Detail

MEDICARE: DR. DANIEL BUSTILLOS DNP, PMHNP-BC

MEDICARE: DR. DANIEL BUSTILLOS DNP, PMHNP-BC
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse856453TX
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP140763TX

General Provider Information

NPI Number : 1881182160
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL BUSTILLOS DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 201 E MAIN DR STE 600
Second Line :
City : EL PASO
State : TX
Zip : 79901-1385
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1219 BARRANCA DR
Second Line :
City : EL PASO
State : TX
Zip : 79935-4601
Country : US
Telephone Number : 915-779-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2018
Last Update Date : 03/05/2024

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