Bustamante Bernal, Marco Antonio

Bustamante Bernal, Marco Antonio is an individual health care provider with primary practice located at 125 W Hague Rd Ste 590, El Paso TX 79902-5808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Bustamante Bernal, Marco Antonio can be contacted via phone (915) 532-1620.

Contact Information

Primary practice address
125 W Hague Rd Ste 590 El Paso TX 79902-5808
Phone: (915) 532-1620
Fax: (915) 544-3852
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X R4017 Texas

Profile Details

NPI number 1841602117
LBN Legal business name Bustamante Bernal, Marco Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2014
Last updated Jul 8th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841602117 NPPES
Texas MEDICAID 382214002

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