Texas Bluebonnet Home Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

009709 Issued in TX

Legal business name

TEXAS BLUEBONNET HOME CARE INC

Doing business as

Bluebonnet Home Care

Practice address

211 N Newsom St
Suite a
Mineola, TX 75773-2133

Phone

(903) 763-2058

Fax

(903) 763-2067

NPI assigned

Dec 14, 2006

Last updated

Jun 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George M Fettinger

Title

Administrator Ceo

Phone

(817) 275-1040

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bluebonnet Home Care Doing business as

Locations

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1972665420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 W PIONEER PKWY STE B",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760134517",
            "telephone_number": "903-763-2058",
            "fax_number": "903-763-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N NEWSOM ST",
            "address_2": "SUITE A",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757732133",
            "telephone_number": "903-763-2058",
            "fax_number": "903-763-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS BLUEBONNET HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "FETTINGER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR CEO",
        "authorized_official_telephone_number": "817-275-1040"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181840301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebonnet Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Mineola, TX
• Providers in Mineola, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.