MEDICARE: BLUE CARE MEDICAL 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1477355147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE CARE MEDICAL LLC

Provider Business Mailing Address
First Line	:	3214 PINE RUN DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2987
Country	:	US
Telephone Number	:	973-776-4736
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 LOUETTA RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-4648
Country	:	US
Telephone Number	:	973-776-4736
Fax Number	:

Authorized Official
Title or Position	:	MANAGER OWNER
Name	:	MR. NELSON LARA DA LUZ JR.
Credential	:
Telephone Number	:	973-776-4736

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/31/2025

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