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MALLORY MARIE BUSTOS
NPI 1912797630
Counselor - Professional in San Antonio, TX

Active since May 07, 2025PECOS Enrolled
1226 STABLE GLEN DR, SAN ANTONIO, TX 78245(210) 317-9624 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2026, May 7, 2025 (2 updates tracked since 2025).

About Mallory Marie Bustos NPPES

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

MALLORY MARIE BUSTOS (NPI 1912797630) is an individual professional provider in San Antonio, Texas, licensed in Texas (92415) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1912797630
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMALLORY MARIE BUSTOS
Location Address1226 STABLE GLEN DRSan Antonio, TX 78245-2969
Mailing Address1226 Stable Glen DrSan Antonio, TX 78245-2969 · (210) 317-9624
Phone(210) 317-9624
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateMay 7, 2025
Last NPPES UpdateMay 18, 20262 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1912797630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 92415
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License MH27163 (FL)
1226 STABLE GLEN DR, San Antonio, TX 78245
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Marie Bustos is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527570613
PECOS Enrollment IDI20250624003708
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Mallory Bustos's NPI number?

The NPI number for Mallory Bustos is 1912797630. It was assigned to this individual provider in the NPPES registry on May 7, 2025.

Where is Mallory Bustos located?

Mallory Bustos practices at 1226 Stable Glen Dr, San Antonio, TX 78245. The listed phone number is (210) 317-9624.

What is Mallory Bustos's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Mallory Bustos enrolled in Medicare?

Yes. Mallory Bustos is registered in the Medicare PECOS enrollment system.

What insurance does Mallory Bustos accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Mallory Bustos as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mallory Bustos was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.