Provider Demographics
NPI:1467209452
Name:BLUE BEE COLLECTIVE, PLLC
Entity type:Organization
Organization Name:BLUE BEE COLLECTIVE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHASITY
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-673-0122
Mailing Address - Street 1:1000 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-4017
Mailing Address - Country:US
Mailing Address - Phone:817-673-0122
Mailing Address - Fax:682-708-2610
Practice Address - Street 1:1000 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-4017
Practice Address - Country:US
Practice Address - Phone:817-673-0122
Practice Address - Fax:682-708-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy