Gustavo Boeta-Lopez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

V9856 Issued in TX

Practice address

1941 S Interstate 35 Ste 101
San Marcos, TX 78666-6169

Phone

(210) 233-7000

NPI assigned

Mar 21, 2022

Last updated

Jul 31, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

St Davids Carenow Urgent Care PLLCGroup PAC ID 4284918418, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridgeway Hospice, LLC. Hospice, Buda, TX, CCN 971719
• Ascension Seton Edgar B Davis Hospital, Luling, TX, CCN 451371
• Post Acute Medical at Luling LLC Long-term care hospital, Luling, TX, CCN 452062

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gustavo.boeta.lopez.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• St. David's Carenow Urgent Care PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1851844104
  Medicare reassignment Care Compare group NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  dba CommuniCare Health Centers

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1902883739
  Medicare reassignment NPD (past)
• Privia Medical Group Gulf Coast PLLC

  dba Express Pain and Urgent Care

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  dba Communicare Health Centers

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1386882231
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Seton

  dba Ascension Seton Edgar B Davis

  • Critical Access Hospital
  • Luling, TX
  • NPI 1356446686
  Care Compare affiliation
• Ascension Seton

  dba Ascension Seton Edgar B Davis

  • Medicare Defined Swing Bed Hospital Unit
  • Luling, TX
  • NPI 1962507202
  Care Compare affiliation
• Bridgeway Hospice LLC

  • Community Based Hospice Care Agency
  • Buda, TX
  • NPI 1255934980
  Care Compare affiliation
• Post Acute Medical at Luling LLC

  dba PAM Specialty Hospital of Luling

  • Long Term Care Hospital
  • Luling, TX
  • NPI 1114962842

  Long-term care hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1275282873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 S INTERSTATE 35 STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666169",
            "telephone_number": "210-233-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 S INTERSTATE 35 STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666169",
            "telephone_number": "210-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETA-LOPEZ",
        "first_name": "GUSTAVO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-21",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V9856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allison Robin Bodle, LM
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• Dana Pebble Borremans, LPC
• Christina Borsellino
• Dana R Bourke, NP

• Family Medicine Physician in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.