MARIO BUSTAMANTE MD PA (NPI# 1477757334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477757334 |
| Entity Type | Organization |
| Organization Name | MARIO BUSTAMANTE MD PA |
| Practice Address |
12770 Cimarron Path Suite 132 San Antonio TX 78249-3416 |
| Practice Telephone | 2107331802 |
| Practice Fax Number | 2107331808 |
| Mailing Telephone | 2107331802 |
| Mailing Fax Number | 2107331808 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2016-01-05 |
| Authorized Official Name | MRS. LETICIA A CANTU (BILLING MANAGER) |
| Authorized Official Telephone | 2107331802 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | C14004 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS GROUP | 0076MN | 01 |
| TX | 168353401 | 05 |
| Street Address |
12770 CIMARRON PATH SUITE 132 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78249-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821033283 | Adept Two Home Health Inc. | Home Health | 12770 Cimarron Path, 134, San Antonio, TX 78249-3427 | 2006-06-19 |
| 1346528833 | Christopher G. Wallace | Physician Assistant | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3427 | 2011-08-01 |
| 1417271545 | Laura M Dixon | Physician Assistant | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3416 | 2010-03-18 |
| 1730355926 | Alamo Rehabilitation Center Assoc | Psychologist | 12770 Cimarron Path, 132, San Antonio, TX 78249-3416 | 2008-05-07 |
| 1285856591 | San Antonio Medical Clinic Pa | Specialist | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3427 | 2007-05-03 |
| 1972640084 | Therapy 180, LLC | Physical Therapist | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3427 | 2007-01-30 |
| 1124196563 | Tony Michael Valdez | Occupational Therapist | 12770 Cimarron Path, 132, San Antonio, TX 78249-3427 | 2006-12-02 |
| 1043384068 | James Edward Robertson | Occupational Therapist | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3427 | 2006-11-20 |
| 1043382906 | Charles Ray Hunter Sr. | Occupational Therapist | 12770 Cimarron Path, Suite 132, San Antonio, TX 78249-3427 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1417566548 | Heenaben Jayantilal Rathod | Registered Nurse | 5803 Utsa Blvd, Apt #2101, San Antonio, TX 78249 | 2020-07-24 |
| 1306455530 | Z-pediatrics Pllc | Pediatrics | 5886 Dezavala Rd Suite 101 #510, San Antonio, TX 78249 | 2020-07-23 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1265071203 | Caralyne Sandquist | Physician Assistant | 5510 Presidio Parkway, Building #2 Suite 2401, San Antonio, TX 78249 | 2019-12-21 |
| 1104472935 | Adam J Gordon | Social Worker | 6363 Dezavala Rd, San Antonio, TX 78249 | 2019-08-16 |
| 1336700582 | Michael Leland Post | Specialist/Technologist | 5150 Dezavala, San Antonio, TX 78249 | 2019-06-27 |
| 1043788722 | Stephen John Reynolds | Counselor | 5907 Trent Rnch, San Antonio, TX 78249 | 2018-11-11 |
| 1396211504 | Christina Michelle Morales | Specialist/Technologist | 4533 N Loop 1604 E, Ste 1119, San Antonio, TX 78249 | 2018-10-16 |
| Find all providers in zip 78249 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568904175 | Ashlee Anderjeski | Specialist | 10218 Castello Cyn, San Antonio, TX 78254-4551 | 2016-11-14 |
| 1831641059 | Lone Star Cardiovascular Center Pllc | Specialist | 9130 Wurzbach Rd Ste 104, San Antonio, TX 78240-1070 | 2016-11-04 |
| 1851753396 | Coral Ramirez Camacho | Specialist | 7827 Clos Du Bois, San Antonio, TX 78253-4880 | 2016-03-23 |
| 1174984371 | Crossover Health | Specialist | 3838 Rogers Rd, San Antonio, TX 78251-3662 | 2016-03-15 |
| 1033585948 | Job Adventures | Specialist | 4606 Centerview Ste 200, San Antonio, TX 78228-1205 | 2015-08-14 |
| 1790168417 | San Antonio Head & Neck Surgical Associates | Specialist | 926 Booklyn Ave, San Antonio, TX 78215-1637 | 2015-06-30 |
| 1255738514 | Amy Beth Flores | Specialist | 7134 Washita Way, San Antonio, TX 78256-2339 | 2014-12-01 |
| 1730582263 | Womens Center At Westover Hills | Specialist | 1315 N. Ellison Dr., San Antonio, TX 78251 | 2014-09-29 |
| 1811396799 | Intravascular Access Team | Specialist | 8415 Fredericksburg Rd, Unit 906, San Antonio, TX 78229-3173 | 2014-08-17 |
| 1497164990 | Next Generation Orthopedic & Spine Institute, Pllc | Specialist | 1626 Lockhill Selma Rd, Suite 2, San Antonio, TX 78213-1929 | 2014-08-08 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78249 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.