| Bluebonnet Trails Community Mhmr Center | |
|
1009 N Georgetown St Round Rock TX 78664-3289 | |
| (512) 255-1720 | |
| (512) 244-8371 |
| Full Name | Bluebonnet Trails Community Mhmr Center |
|---|---|
| Speciality | Clinic/center - Developmental Disabilities |
| Location | 1009 N Georgetown St, Round Rock, Texas |
| Authorized Official Name and Position | Noralisa Williams (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5122448374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluebonnet Trails Community Mhmr Center 1009 N Georgetown St Round Rock TX 78664-3289 Ph: (512) 255-1720 | Bluebonnet Trails Community Mhmr Center 1009 N Georgetown St Round Rock TX 78664-3289 Ph: (512) 255-1720 |
| NPI Number | 1861534612 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861534612 | NPI | - | NPPES |
| 1268443 03 | Medicaid | TX |
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