# BLUEBONNET TRAILS COMMUNITY MHMR CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861534612
- **Authorized official:** MS. NORALISA WILLIAMS (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (512) 244-8374

## Contact information

- **Practice address:** 1009 N GEORGETOWN ST, ROUND ROCK, TX 78664-3289
- **Practice address phone:** (512) 255-1720
- **Practice address fax:** (512) 244-8371
- **Mailing address:** 1009 N GEORGETOWN ST, ROUND ROCK, TX 78664-3289
- **Mailing address phone:** (512) 255-1720
- **Mailing address fax:** (512) 244-8371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | NO LICENSE | TX | — |
| 133V00000X | Registered Dietitian | — | TX | — |
| 171R00000X | Interpreter | — | TX | — |
| 225100000X | Physical Therapist | — | TX | — |
| 225X00000X | Occupational Therapist | — | TX | — |
| 235Z00000X | Speech-Language Pathologist | — | TX | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | NO LICENSE | TX | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 08/28/2023