Brenda D Bustillos, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT80151 Issued in TX

Practice address

4301 Mow-Way Road (McUa-NCD)
CDR Usameddac
Fort Sill, OK 73503-6300

Phone

(580) 458-3055

Fax

(580) 458-2846

NPI assigned

Jan 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1689851628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131",
            "city": "MEDICINE PARK",
            "state": "OK",
            "postal_code": "735570131",
            "telephone_number": "580-458-3055",
            "fax_number": "580-458-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MOW-WAY ROAD (MCUA-NCD)",
            "address_2": "CDR USAMEDDAC",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735036300",
            "telephone_number": "580-458-3055",
            "fax_number": "580-458-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLOS",
        "first_name": "BRENDA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilla Brown
• Eryn Christine Bull, LCSW
• Lauren Bunch, RN
• Craig Embertson Bundy, DDS
• Jarom R Burbank, DDS
• Stephen Michael Byrne, DDS
• Michelle R Cannon, MS, LPC
• Candace Carle, LCSW
• Kelly E Carlen, DDS
• Edwin Carns Jr., MD

• Registered Dietitian in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.