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General NPI Number Information
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NPI Number | 1477355147
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Entity Type | Organization
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Legal Business Name | BLUE CARE MEDICAL LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 2810 LOUETTA RD
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City | SPRING
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State | TX
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Zip | 77388-4648
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Country | US
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Telephone | 973-776-4736
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Fax |
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Provider Business Mailing Address
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Address Line | 3214 PINE RUN DR
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City | SPRING
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State | TX
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Zip | 77388-2987
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Country | US
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Telephone | 973-776-4736
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Fax |
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Authorized Official
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Title or Position | MANAGER OWNER
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Name | MR. NELSON LARA DA LUZ JR.
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Credential |
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Telephone | 973-776-4736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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