Organization
BLUEBONNET FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN PEREZ M.D. (DIRECTOR)
(325) 655-7969
Entity
Organization
Contact information
Practice address
2030 PULLIAM ST, SAN ANGELO, TX 76905-5175
(325) 653-0800
Mailing address
223 S ABE ST, SAN ANGELO, TX 76903-6305
(325) 655-7969
(325) 655-7976
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F9940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045MA
BCBS OF TX
TX
Enumeration date
08/18/2006
Last updated
10/23/2007
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