Bustillo, Mayra S.

Bustillo, Mayra S. is an individual health care provider with primary practice located at 1115 Weber St , Franklin LA 70538-4124. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as her primary health care specialty. Bustillo, Mayra S. can be contacted via phone (337) 828-2550.

Contact Information

Primary practice address
1115 Weber St Franklin LA 70538-4124
Phone: (337) 828-2550
Fax: (337) 355-2335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X L6308 Texas
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 12129R Louisiana

Profile Details

NPI number 1740231430
LBN Legal business name Bustillo, Mayra S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Jun 17th, 2022 - about 3 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 1740231430 NPPES
Texas MEDICAID 081278601
Texas MEDICAID 1533467

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