Texas Bluebonnet Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

TEXAS BLUEBONNET PHARMACY

Practice address

808 Utility Rd
Sanger, TX 76266-9131

Phone

(940) 458-3184

Fax

(940) 458-9175

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. George Fettinger, CPA

Title

Ceo

Phone

(817) 275-1040

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154484210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 UTILITY RD",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762669131",
            "telephone_number": "940-458-3184",
            "fax_number": "940-458-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 UTILITY RD",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762669131",
            "telephone_number": "940-458-3184",
            "fax_number": "940-458-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS BLUEBONNET PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FETTINGER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-275-1040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4544513",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TXSTATE BOARD OF PHARMACY",
            "identifier": "25470",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145822",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SURESCRIPTS",
            "identifier": "0899813574",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariangela Zo Stewart
• Nicholas Stratso, D.C.
• Sydney Taylor
• Stacie J. Test, D.D.S.
• Texas Blue Bonnet Durable Medical Equipment Conpany Inc.
• Kody Joe Truebenbach, DPT
• Laura Jane Tunnicliff
• Ashley Ann Turner, RN, BSN
• TX Blubonnet Durable Medical Equipment Co, Inc.
• Velocity Physical Therapy, LLC

• Pharmacy in Sanger, TX
• Providers in Sanger, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.