| Bluebonnet Trails Community Mhmr Center | |
|
750 W Travis St La Grange TX 78945-2522 | |
| (979) 968-3711 | |
| Not Available |
| Full Name | Bluebonnet Trails Community Mhmr Center |
|---|---|
| Speciality | Family Medicine |
| Location | 750 W Travis St, La Grange, Texas |
| Authorized Official Name and Position | Andrea Richardson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5122448305 |
| 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: () - | Bluebonnet Trails Community Mhmr Center 750 W Travis St La Grange TX 78945-2522 Ph: (979) 968-3711 |
| NPI Number | 1215682752 |
|---|---|
| Provider Enumeration Date | 02/14/2022 |
| Last Update Date | 08/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215682752 | NPI | - | NPPES |
| 1268443-05 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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