NPIMap

Organization Active NPI

Bluebonnet Trails Community MHMR Center

  • Developmental Disabilities Clinic/Center
  • Round Rock, TX
National Provider Identifier
1861534612
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
NO LICENSE Issued in TX
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) 244-8371
NPI assigned
Feb 12, 2007
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
Ms. Noralisa Williams
Title
Credentialing Coordinator
Phone
(512) 244-8374

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X NO LICENSE TX
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X TX
InterpreterGroup: 193200000X MULTI-SPECIALTY GROUP 171R00000X TX
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X TX
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X TX
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X TX
Developmental Disabilities Clinic/Center 261QD1600X NO LICENSE TX 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 identifiers 1

IdentifierTypeStateIssuer
1268443 03MedicaidTX

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1861534612",
    "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": "512-244-8371"
        },
        {
            "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": "512-244-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET TRAILS COMMUNITY MHMR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NORALISA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "512-244-8374",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Interpreter",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268443 03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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.