Individual provider Active NPI

Alejandro Bustamante-Laue, MD

  • Family Medicine Physician
  • Odessa, TX
National Provider Identifier
1740867977
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V1044 Issued in TX
Practice address
701 W 5TH St Ste 1229
Odessa, TX 79763-4206
Phone
(432) 703-5238
NPI assigned
Mar 25, 2021
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V1044 TX Primary

Addresses

Primary practice location

701 W 5TH St Ste 1229
Odessa, TX 79763-4206

Mailing address

701 W 5TH St Ste 1229
Odessa, TX 79763-4206
Phone (432) 703-5238

Other practice location 1

774 Landa St
New Braunfels, TX 78130-6114
Phone (830) 625-0305

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240729001174 TX Practitioner - Family Practice 5496157133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

3405 El Salido Pkwy
Cedar Park, TX 78613-5640
Phone (512) 270-2247

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

774 Landa St
New Braunfels, TX 78130-6114
Phone (830) 625-0298

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
94.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Sep 3, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 3, 2024 Accepting new patients

Locations

774 Landa St
New Braunfels, TX 78130
Phone (830) 625-0298

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: abustamantelaue389604@christushealth.direct-ci.net
  • Direct secure messaging: alejandro.bustamantelaue.p1@direct.preventativehealth.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1740867977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST STE 1229",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-703-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST STE 1229",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-703-5238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "774 Landa St",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781306114",
            "country_code": "US",
            "telephone_number": "830-625-0305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE-LAUE",
        "first_name": "ALEJANDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V1044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.