Active NPI
Fernando Jose Bueso Jr., MD.LSA
- Physician Assistant
- Houston, TX
National Provider Identifier
1154539146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- LSA-05-168
- Practice address
- 4655 Wild Indigo St Apt 274
Houston, TX 77027-7076 - Phone
- (713) 882-9849
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | LSA-05-168 | TX | Primary |
Addresses
Primary practice location
4655 Wild Indigo St Apt 274
Houston, TX 77027-7076
Mailing address
PO Box 111938
Houston, TX 77293-0938
Phone (713) 882-9849
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSA-05-168 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154539146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 111938",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772930938",
"telephone_number": "713-882-9849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4655 WILD INDIGO ST APT 274",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770277076",
"telephone_number": "713-882-9849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUESO",
"first_name": "FERNANDO",
"middle_name": "JOSE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD.LSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "LSA-05-168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.