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General NPI Number Information
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NPI Number | 1669380713
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Entity Type | Organization
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Legal Business Name | BLUEBIRD PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR # 33198
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 847-701-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR # 33198
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 847-701-4470
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BENJAMIN BRYKS
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Credential |
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Telephone | 847-701-4470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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