Provider Demographics
NPI:1457128423
Name:BLUEPUS PLLC
Entity type:Organization
Organization Name:BLUEPUS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTNI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-640-1382
Mailing Address - Street 1:810 N DIXIE DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLUTE
Mailing Address - State:TX
Mailing Address - Zip Code:77531-1518
Mailing Address - Country:US
Mailing Address - Phone:832-640-1382
Mailing Address - Fax:
Practice Address - Street 1:4427 CRENSHAW RD STE 140
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3628
Practice Address - Country:US
Practice Address - Phone:979-341-9890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1134551476OtherDENTIST