NPIMap

Organization Active NPI

Bluebonnet Trails Community MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
National Provider Identifier
1124426226
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLUEBONNET TRAILS COMMUNITY MHMR CENTER
Practice address
1009 N Georgetown St
Round Rock, TX 78664-3289
Phone
(512) 255-1720
Fax
(512) 727-0130
NPI assigned
Dec 5, 2014
Reactivated
Jun 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Peter Gallimore
Title
Credentialing Coordinator
Phone
(512) 244-8374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1009 N Georgetown St
Round Rock, TX 78664-3289

Mailing address

1009 N Georgetown St
Round Rock, TX 78664-3289
Phone (512) 255-1720

Other names 1

  • Bluebonnet Trails Community Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bluebonnet Trails MHMR Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1124426226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-727-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-727-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET TRAILS COMMUNITY MHMR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "deactivation_date": "2021-11-29",
        "reactivation_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "GALLIMORE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "512-244-8374",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebonnet Trails Community Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluebonnet Trails Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.