BLUEBONNET TRAILS COMMUNITY SERVICES (NPI# 1336576099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336576099 |
| Entity Type | Organization |
| Organization Name | BLUEBONNET TRAILS COMMUNITY SERVICES |
| Practice Address |
1009 N Georgetown St Round Rock TX 78664-3289 |
| Practice Telephone | 5122551720 |
| Mailing Telephone | 5122551720 |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-10-03 |
| Authorized Official Name | DIANE OEHLERS (REIMBERUSEMENT DIRECTOR) |
| Authorized Official Telephone | 8308755700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
3646-3649 | TX | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BLUEBONNET TRAILS COMMUNITY SERVICES | 1009 N Georgetown St, Round Rock, TX 78664-3289 |
| Street Address |
1009 N GEORGETOWN ST |
| City | ROUND ROCK |
| State | TX |
| Zip Code | 78664-3289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447237078 | David William Coghe | Psychiatry & Neurology | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2005-12-23 |
| 1487254611 | Savannah Howe | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-10-27 |
| 1912518051 | Kimberly Dragon | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-08-12 |
| 1255967881 | Jasmin Jaimes | Social Worker | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-03-16 |
| 1700411485 | Lauren Moreno | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-03-03 |
| 1710510169 | Diane Dinsmore | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-02-13 |
| 1316578172 | Sara Cunningham | Behavioral Analyst | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2020-01-30 |
| 1093351033 | Judith Crumrine | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2019-11-25 |
| 1386289247 | Yvette Welch | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2019-11-14 |
| 1740836584 | Jovanna Kenney | Counselor | 1009 N Georgetown St, Round Rock, TX 78664-3289 | 2019-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710526900 | Yan Wei Chan | Acupuncturist | 894 Summit St. Suite 109, Round Rock, TX 78664 | 2020-01-06 |
| 1285139030 | Coffee Rx LLC | Pharmacy | 106 S Mays St Ste 100, Round Rock, TX 78664 | 2018-03-26 |
| 1508369224 | Daniel Bernard Hall | Nurse Practitioner | 1700 East Palm Valley Blvd, Roundrock, TX 78664 | 2018-03-09 |
| 1407361561 | Double Creek Assisted Living Lp | Assisted Living Facility | 3200 Louis Henna Blvd., Round Rock, TX 78664 | 2017-12-11 |
| 1396254694 | Gezahgne T Bogale | Driver | 1908 Huxley Ln, Round Rock, TX 78664 | 2017-09-29 |
| 1942728563 | Kathryn Dufresne | Massage Therapist | 896 Summit Street Suite 104b, Round Rock, TX 78664 | 2017-09-04 |
| 1699213686 | I&r Health Services | Case Management | 2501 Louis Henna Blvd Apt 914, Round Rock, TX 78664 | 2017-02-09 |
| 1588018394 | The Heidi Group | Family Medicine | 894 Summit St Ste 108, Round Rock, TX 78664 | 2016-04-18 |
| 1902264963 | Round Rock Emergency Physicians | Clinic/Center | 1925 Aw Grimes Blvd, Round Rock, TX 78664 | 2016-02-05 |
| 1508230137 | Michael Fuentes | Community Health Worker | 117-b Louis Henna Blvd, Ste. 200, Round Rock, TX 78664 | 2015-11-19 |
| Find all providers in zip 78664 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386958734 | Tri-county Recovery Center A Texas Non-profit Corporation | Clinic/Center | 2107 N Mays St, Round Rock, TX 78664-2155 | 2010-07-27 |
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| 1154953917 | Finch Clinic, Pllc. | Clinic/Center | 1105 Memorial Dr Ste 102, Denison, TX 75020-2043 | 2020-02-10 |
| 1265063689 | Cenikorfoundation | Clinic/Center | 5501 Interstate Hwy 37, Corpus Christi, TX 78408 | 2020-02-04 |
| 1598306862 | Ethos Wellness-the Prairie Recovery Center | Clinic/Center | 5808 Wagner Rd, Round Top, TX 78954-5075 | 2019-10-08 |
| 1619539509 | Arc Counseling LLC | Clinic/Center | 5700 Nw Central Dr Ste 130, Houston, TX 77092-2000 | 2019-07-01 |
| 1982261988 | Davecolephd and Associates | Clinic/Center | 4702 Old Spanish Trl Ste 106, Houston, TX 77021-1718 | 2019-05-24 |
| Find all providers with the same taxonomy | ||||
| City | ROUND ROCK |
| Zip Code | 78664 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.