| Bluebonnet Trails Community Services | |
|
750 W Travis St La Grange TX 78945-2522 | |
| (512) 255-1720 | |
| (512) 244-8401 |
| Full Name | Bluebonnet Trails Community Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 750 W Travis St, La Grange, Texas |
| Authorized Official Name and Position | Andrea Richardson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5122448305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluebonnet Trails Community Services 1009 N Georgetown St Round Rock TX 78664-3289 Ph: (512) 255-1720 | Bluebonnet Trails Community Services 750 W Travis St La Grange TX 78945-2522 Ph: (512) 255-1720 |
| NPI Number | 1518536309 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 5799775409 |
|---|---|
| Medicare Enrollment ID | O20220106001389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518536309 | NPI | - | NPPES |
| 1268443-05 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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