MEDICARE: BLUE BONNET PA

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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1295103349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE BONNET PA

Provider Business Mailing Address
First Line	:	7505 FANNIN ST STE 211
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1953
Country	:	US
Telephone Number	:	713-750-9045
Fax Number	:	832-667-8162

Provider Business Practice Location Address
First Line	:	7505 FANNIN ST STE 211
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1953
Country	:	US
Telephone Number	:	713-750-9045
Fax Number	:	832-667-8162

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. IGNACIO H. VALDES
Credential	:	M.D.
Telephone Number	:	713-750-9045

Provider Enumeration Date	:	09/07/2015
Last Update Date	:	04/23/2026

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Directions to “BLUE BONNET PA ” Practice Location

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