Provider Demographics
NPI:1326535436
Name:BUSTAMANTE, CLAIRE E (PNP)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:E
Last Name:BUSTAMANTE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 SAN PEDRO AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2009
Mailing Address - Country:US
Mailing Address - Phone:210-281-8669
Mailing Address - Fax:210-314-5044
Practice Address - Street 1:20821 US HIGHWAY 281 N STE 324
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7597
Practice Address - Country:US
Practice Address - Phone:210-998-4758
Practice Address - Fax:210-314-5044
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136805363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics