Healthcare Provider Details

I. General information

NPI: 1982568630
Provider Name (Legal Business Name): ROYAL BLUEBIRD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 UNIVERSITY BLVD APT 1418
ROUND ROCK TX
78665-8029
US

IV. Provider business mailing address

1700 UNIVERSITY BLVD. BELL AT TERAVISTA, APT. 1418
ROUND ROCK TX
78665
US

V. Phone/Fax

Practice location:
  • Phone: 737-328-4859
  • Fax:
Mailing address:
  • Phone: 737-328-4859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUTABA HASSAN
Title or Position: MANAGER
Credential: SOLE MBR
Phone: 737-328-4859