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General NPI Number Information
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NPI Number | 1518847094
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Entity Type | Organization
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Legal Business Name | TEXAS BLUE LAKE POOLS, INC.
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2422 COMMERCE ST
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City | AMARILLO
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State | TX
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Zip | 79109-1514
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Country | US
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Telephone | 806-358-4551
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Fax | 806-355-3931
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Provider Business Mailing Address
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Address Line | 2422 COMMERCE ST
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City | AMARILLO
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State | TX
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Zip | 79109-1514
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Country | US
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Telephone | 806-358-4551
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Fax | 806-355-3931
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | BRYAN GEORGE
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Credential |
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Telephone | 806-358-4551
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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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