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SUSAN L. BOULLIOUN, M.D., P.A.
NPI 1588801609
Family Medicine in Seguin, TX

Active since January 12, 2009CLIA 45D0981427 · Waiver
113 E. CEDAR ST., SEGUIN, TX 78155(830) 303-3500(830) 303-9399 Get Directions Write a Review

NPPES record last updated: January 7, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Susan L. Boullioun, M.d., P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN L. BOULLIOUN, M.D., P.A. (NPI 1588801609) is a healthcare organization registered as a family medicine in Seguin, Texas and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through December 26, 2026 and lists Susan Lorton Boullioun, President, as its authorized official.

NPPES Registry Identity

NPI1588801609
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSUSAN L. BOULLIOUN, M.D., P.A.
Location Address113 E. CEDAR ST.Seguin, TX 78155-3709
Mailing Address113 E Cedar StSeguin, TX 78155-3709 · (830) 303-3500 · Fax (830) 303-9399
Phone(830) 303-3500
Fax(830) 303-9399
Organization SubpartNo
Authorized OfficialSusan Lorton BoulliounPresident · (830) 303-3500
Enumeration DateJanuary 12, 2009
Last NPPES UpdateJanuary 7, 2010
✔ NPI 1588801609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · K2312
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
113 E. CEDAR ST., Seguin, TX 78155
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Other Identifiers 3

Medicare UPING47665TX
Medicaid121420702TX
Medicaid121420704TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan L. Boullioun, M.d., P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Susan L. Boullioun, M.D., P.A., which bills Medicare for the services this clinician delivers.

Clinician (1)

Susan Boullioun, MD
Family Practice
NPI 1528148889
113 E CEDAR ST
Seguin, TX 78155
(830) 303-3500
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0981427

Susan Boullioun MD PA · Seguin, TX
Active · expires Dec 26, 2026
CLIA Number45D0981427
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2024
Certificate Expiration DateDecember 26, 2026
Laboratory DirectorSusan L. Boullioun
Laboratory Phone(830) 303-3500
Laboratory LocationSusan Boullioun MD PA113 E Cedar Street, Seguin, TX 78155
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan L. Boullioun, M.D., P.A.'s NPI number?

The NPI number for Susan L. Boullioun, M.D., P.A. is 1588801609. It was assigned to this organization in the NPPES registry on January 12, 2009.

Where is Susan L. Boullioun, M.D., P.A. located?

Susan L. Boullioun, M.D., P.A. is located at 113 E. Cedar St., Seguin, TX 78155. The listed phone number is (830) 303-3500.

What is Susan L. Boullioun, M.D., P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Susan L. Boullioun, M.D., P.A. enrolled in Medicare?

Yes. Susan L. Boullioun, M.D., P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Susan L. Boullioun, M.D., P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Susan L. Boullioun, M.D., P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Susan L. Boullioun, M.D., P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0981427) is associated with this NPI, valid through December 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Susan L. Boullioun, M.D., P.A. was last updated on January 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.