Provider Demographics
NPI:1033978200
Name:BSR.I LLC
Entity Type:Organization
Organization Name:BSR.I LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA BONEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-618-6619
Mailing Address - Street 1:4110 ALMEDA RD # 8447
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-4869
Mailing Address - Country:US
Mailing Address - Phone:832-618-6619
Mailing Address - Fax:
Practice Address - Street 1:2503 ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6077
Practice Address - Country:US
Practice Address - Phone:832-618-6619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty