Provider Demographics
NPI:1316577216
Name:BLUEBONNET PEDIATRICS PLLC
Entity Type:Organization
Organization Name:BLUEBONNET PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-333-9533
Mailing Address - Street 1:790 GENERATIONS DR STE 215
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-0089
Mailing Address - Country:US
Mailing Address - Phone:830-333-9533
Mailing Address - Fax:830-626-8000
Practice Address - Street 1:790 GENERATIONS DR STE 215
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0089
Practice Address - Country:US
Practice Address - Phone:830-333-9533
Practice Address - Fax:830-626-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-20
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty