Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1912797630 Individual Practitioner Female Practitioner

Mallory Marie Bustos

Counselor - Professional • San Antonio, TX

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Mallory Bustos is a registered Counselor - Professional practitioner in San Antonio, TX. With approximately 11 years of clinical practice since completing medical education in 2015, Mallory Bustos provides healthcare services at the registered practice location at 1226 STABLE GLEN DR.

Mallory Bustos does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1226 Stable Glen Dr

San Antonio, TX 782452969

Telephone 2103179624

Medicare Profile & Education

Medical School

Other

Graduation Year

2015

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in San Antonio, TX

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
11 Yrs -2.2 yrs vs City Avg
City Avg: 13.2 Yrs
State Avg: 14.1 Yrs
Regional Practice Density
1882 Specialists

Practicing in San Antonio, TX (21203 Statewide)

Telehealth Adoption Rate
3.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Bustos (11 Years) 11 Yrs
San Antonio Specialty Average (13.2 Years) 13.2 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-05-18
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License TX 92415

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License FL MH27163

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 07, 2025

NPI status registered as active in NPPES database

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Updated Practice Location May 07, 2025

Registered at 1226 STABLE GLEN DR, SAN ANTONIO, TX 782452969 (Tel: 2103179624)

📍
Updated Business Mailing Address May 07, 2025

Registered at 1226 STABLE GLEN DR, SAN ANTONIO, TX 782452969 (Tel: 2103179624)

👤
Provider Name / Credentials Updated May 07, 2025

Recorded as MALLORY BUSTOS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 07, 2025

Counselor (License #92415 in TX)

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Initial NPI Registration & Enumeration May 07, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1912797630
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 07, 2025
Last Update: May 18, 2026
Sole Proprietor: Yes

Mailing Address

1226 Stable Glen Dr

San Antonio, TX 782452969

Phone: 2103179624

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.