Individual provider Active NPI

Lu Ann Laird Bundrant, MD

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1700812989
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K2858 Issued in TX
Practice address
7000 North Mopac
Suite # 420
Austin, TX 78731
Phone
(512) 482-0045
Fax
(512) 476-9892
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K2858 TX Primary

Addresses

Primary practice location

7000 North Mopac
Suite # 420
Austin, TX 78731

Mailing address

7000 North Mopac
Suite # 420
Austin, TX 78731
Phone (512) 482-0045

Other identifiers 2

IdentifierTypeStateIssuer
104530403MedicaidTX
11045304-03MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1700812989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 NORTH MOPAC",
            "address_2": "SUITE # 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-482-0045",
            "fax_number": "512-476-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 NORTH MOPAC",
            "address_2": "SUITE # 420",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-482-0045",
            "fax_number": "512-476-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDRANT",
        "first_name": "LU ANN",
        "middle_name": "LAIRD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K2858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104530403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11045304-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.