My Bluebonnet Company, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MY BLUEBONNET COMPANY, LLC

Doing business as

Medi-Weightloss Austin

Practice address

13359 N Highway 183
Ste403
Austin, TX 78750-7153

Phone

(512) 867-6200

Fax

(512) 519-1127

NPI assigned

Aug 4, 2016

Organization subpart

No

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

Authorized official

Name

Qing Liu

Title

Business Development Manager

Phone

(512) 867-6200

Specialties & licenses 3

Addresses

Other names 1

• Medi-Weightloss Austin Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1366996647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13359 N HIGHWAY 183",
            "address_2": "STE403",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787507153",
            "telephone_number": "512-867-6200",
            "fax_number": "512-519-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13359 N HIGHWAY 183",
            "address_2": "STE403",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787507153",
            "telephone_number": "512-867-6200",
            "fax_number": "512-519-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY BLUEBONNET COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "QING",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT MANAGER",
        "authorized_official_telephone_number": "512-867-6200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi-Weightloss Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.