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Organization
MY BLUEBONNET COMPANY, LLC
Active
Organization
MY BLUEBONNET COMPANY, LLC
Active
Other names
Medi-Weightloss Austin
Organization subpart
No
Provider details
NPI number
Authorized official
QING LIU (BUSINESS DEVELOPMENT MANAGER)
(512) 867-6200
Entity
Organization
Contact information
Practice address
13359 N HIGHWAY 183, STE403, AUSTIN, TX 78750-7153
(512) 867-6200
(512) 519-1127
Mailing address
13359 N HIGHWAY 183, STE403, AUSTIN, TX 78750-7153
(512) 867-6200
(512) 519-1127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/04/2016
Last updated
08/10/2016
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