MR. PABLO ERNESTO BUSTAMANTE JR. (NPI# 1861606501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861606501 |
| Entity Type | Individual |
| Full Name | MR. PABLO ERNESTO BUSTAMANTE JR. |
| Other Name | LOVING AGE AFC LTC |
| Practice Address |
2029 Anise Dr El Paso TX 79935-2619 |
| Practice Telephone | 9155912017 |
| Mailing Telephone | 9155912017 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
TX | Nursing & Custodial Care Facilities |
| Street Address |
2029 ANISE DR |
| City | EL PASO |
| State | TX |
| Zip Code | 79935-2619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093261604 | Julio Alcala | Radiologic Technologist | 10291 Pellicano Suite 102, El Paso, TX 79935 | 2016-09-01 |
| 1760841423 | Anant Shukla | Preventive Medicine | Mendoza Aviation Clinic (11335 Ssg Sims Blvd), El Paso, TX 79935 | 2016-02-23 |
| 1306249834 | Ector County Hospital District | Skilled Nursing Facility | 1599 Lomaland Drive, El Paso, TX 79935 | 2014-09-29 |
| 1164831079 | Elizabeth Espinoza | Pharmacist | 2112 Trawood, El Paso, TX 79935 | 2014-08-05 |
| 1396151759 | The Lasik Vision Institute LLC | Clinic/Center | 10961 Gateway, Suite 300, El Paso, TX 79935 | 2014-07-07 |
| 1427461896 | Henry Vu | Optometrist | 10961 Gateway West, Ste 300, El Paso, TX 79935 | 2014-06-03 |
| 1982947636 | Novoa Medical Services, Pa | Obstetrics & Gynecology | 10781 Pebble Hills, Suite A, El Paso, TX 79935 | 2013-04-01 |
| 1366796724 | New Leaf Wellness Center | Counselor | 10921 Pellicano Dr Ste 110, El Paso, TX 79935 | 2012-11-06 |
| 1295980670 | Amy Latonia Hensley | Massage Therapist | 2278 Trawood Dr., Ste. C, El Paso, TX 79935 | 2008-11-26 |
| 1477752855 | Sunland Optical Co Inc | Durable Medical Equipment & Medical Supplies | 1156 Barranca, El Paso, TX 79935 | 2007-07-16 |
| Find all providers in zip 79935 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275171522 | Gloria Romero Heinrichs | Assisted Living Facility | 10417 Persephone Dr, El Paso, TX 79924-2216 | 2019-12-17 |
| 1982259495 | Cruz Elvia Corral | Assisted Living Facility | 10165 Bermuda, El Paso, TX 79925 | 2019-08-02 |
| 1407330350 | Maria Petra Aguirre | Assisted Living Facility | 3607 E Yandell Dr, El Paso, TX 79903-4410 | 2018-09-17 |
| 1417434994 | Villas Del Sol | Assisted Living Facility | 520 East Rd, El Paso, TX 79915-3005 | 2018-07-26 |
| 1376031112 | Ana Luisa Vega | Assisted Living Facility | 10628 Drillstone Dr, El Paso, TX 79925-1717 | 2018-04-26 |
| 1386140671 | Casa Felicitas 1 Small Assisted Living | Assisted Living Facility | 3330 E Yandell Dr, El Paso, TX 79903-4232 | 2018-04-04 |
| 1508307265 | Minerva Sustaita | Assisted Living Facility | 1845 Tommy Aaron Dr, El Paso, TX 79936 | 2017-03-14 |
| 1184164931 | The Forest Assisted Living, Inc. | Assisted Living Facility | 9355 N Loop Dr, El Paso, TX 79907-4827 | 2017-02-27 |
| 1104362862 | Bernardo M. Terres | Assisted Living Facility | 2218 Mermaid Dr, El Paso, TX 79936-3621 | 2017-01-18 |
| 1013453786 | Cecilia Jauregui Terres | Assisted Living Facility | 11651 Clear Lake Way, El Paso, TX 79936-4382 | 2017-01-18 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.