MARIO BUSTAMANTE MD PA
Medical Practice at Cimarron Path, San Antonio, TX

License number
Texas C14004
Category
Medical Practice
Type
Specialist
Owner
Name: MRS. LETICIA A CANTU
Title: BILLING MANAGER
Phone: (210) 733-1802
Address
Address
12770 Cimarron Path SUITE 132, San Antonio, TX 78249
National Provider ID: 1477757334
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MARIO BUSTAMANTE, MD, PA

343 W Houston St STE 406, San Antonio, TX 78205

Status:
Inactive
Doing business as:
Mario Bustamante, M.D., PA<br>Mario Bustamante, MD, PA
Registration:
Mar 24, 1999
State ID:
0081963703
Business type:
Professional Association
President , Director , Member:
Mario A. Bustamante President , Director , Member, inactive
TIN:
32036002601

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