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NPI Code Detail

MEDICARE: BLUEBONNET PRIMARY HOME CARE LLC

MEDICARE: BLUEBONNET PRIMARY HOME CARE 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1275356446
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUEBONNET PRIMARY HOME CARE LLC
Provider Business Mailing Address
First Line : 1575 MILITARY HWY 281 STE 106
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-3408
Country : US
Telephone Number : 956-517-6260
Fax Number : 956-372-1128
Provider Business Practice Location Address
First Line : 5226 POMANDER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77021-3148
Country : US
Telephone Number : 956-589-5026
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : VANESSA TREVINO
Credential :
Telephone Number : 956-589-5026
Provider Enumeration Date : 11/05/2024
Last Update Date : 11/05/2024

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Directions to “BLUEBONNET PRIMARY HOME CARE LLC ” Practice Location

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