MEDICARE: BCI GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1790577583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BCI GROUP LLC

Provider Business Mailing Address
First Line	:	4 DOMINION DRIVE, BLDG 4
Second Line	:	STE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1488
Country	:	US
Telephone Number	:	210-850-5790
Fax Number	:

Provider Business Practice Location Address
First Line	:	17316 N KIMBERLY WAY
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-9686
Country	:	US
Telephone Number	:	575-491-5367
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. BRENDA L BAKER
Credential	:	APRN
Telephone Number	:	575-491-5367

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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Directions to “BCI GROUP LLC ” Practice Location

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