MEDICARE: BAMBOO HEALTH SERVICES 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1942150289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAMBOO HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1609 BANDED LEDGE DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-4718
Country	:	US
Telephone Number	:	419-775-4471
Fax Number	:	361-400-2358

Provider Business Practice Location Address
First Line	:	1609 BANDED LEDGE DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-4718
Country	:	US
Telephone Number	:	419-775-4771
Fax Number	:	361-400-2358

Authorized Official
Title or Position	:	OWNER
Name	:	EMILY OOGA
Credential	:	PMHNP
Telephone Number	:	419-775-4771

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	02/03/2026

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