Individual provider Active NPI

Ruth Citlalli Bustos, RN

  • Registered Nurse
  • Katy, TX
National Provider Identifier
1053811836
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
939300 Issued in TX
Practice address
4914 Windy Brook LN
Katy, TX 77449-6036
Phone
(346) 412-9168
NPI assigned
Feb 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 939300 TX Primary

Addresses

Primary practice location

4914 Windy Brook LN
Katy, TX 77449-6036

Mailing address

4914 Windy Brook LN
Katy, TX 77449-6036
Phone (346) 412-9168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
939300TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Wings of Wellness Concierge Healthcare Services LLC CurrentSince Feb 1, 2025 Accepting new patients
Wings of Wellness Healthcare Solutions, LLC PastSince Jan 1, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1053811836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 WINDY BROOK LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496036",
            "telephone_number": "346-412-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 WINDY BROOK LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774496036",
            "telephone_number": "346-412-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "RUTH",
        "middle_name": "CITLALLI",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-18",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "939300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.