Shila Bustos

Individual provider Active NPI Pediatrics Physician · Houston, TX

NPI 1821245085 · NPPES record last updated Aug 19, 2008

Key facts

NPI
1821245085
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
M6061 (TX)
Practice address
11509 Veterans Memorial Dr Ste 600
Houston, TX 77067-2629
Phone
(281) 444-7726
Fax
(281) 444-9426
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6061TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hai K Nguyen MD PA Past Accepting new patients
Gregory Peco PA - C Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M6061 TX Yes

Addresses

Primary practice location

11509 Veterans Memorial Dr Ste 600
Houston, TX 77067-2629

Mailing address

11509 Veterans Memorial Dr Ste 600
Houston, TX 77067-2629
Phone (281) 444-7726

Other providers in Houston, TX

All providers in Houston, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.