Active NPI
Bluebonnet Pharmacy Inc
- Pharmacy
- Houston, TX
National Provider Identifier
1639318975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 26367
- Legal business name
- BLUEBONNET PHARMACY INC
- Doing business as
- Bluebonnet Pharmacy Inc
- Practice address
- 1919 North Loop W
Suite 280
Houston, TX 77008-1374 - Phone
- (713) 864-0100
- Fax
- (713) 864-0246
- NPI assigned
- Feb 10, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Suzanne Elgendy
- Title
- Director
- Phone
- (713) 864-0100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 26367 | TX | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1919 North Loop W
Suite 280
Houston, TX 77008-1374
Mailing address
1919 North Loop W
Suite 280
Houston, TX 77008-1374
Phone (713) 864-0100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2118898 | Other | PK | |
| 145996 | Medicaid | TX |
Other names 1
- Bluebonnet Pharmacy Inc
National Provider Directory
National Provider Directory- Tax ID family
- Bluebonnet Pharmacy Inc
Other organizations with this tax ID 1
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": "1234224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1487116800000",
"number": "1639318975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 NORTH LOOP W",
"address_2": "SUITE 280",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770081374",
"telephone_number": "713-864-0100",
"fax_number": "713-864-0246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 NORTH LOOP W",
"address_2": "SUITE 280",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770081374",
"telephone_number": "713-864-0100",
"fax_number": "713-864-0246"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUEBONNET PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-10",
"last_updated": "2017-02-15",
"status": "A",
"authorized_official_last_name": "ELGENDY",
"authorized_official_first_name": "SUZANNE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "713-864-0100"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "26367",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2118898",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145996",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bluebonnet Pharmacy Inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.