Organization
BLUE AGAVE SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CARNEY (PRESIDENT)
(619) 568-6800
Entity
Organization
Contact information
Practice address
15825 CARLTON OAKS DR, FORT WORTH, TX 76177-2162
(972) 849-4000
Mailing address
10109 LAKE CREEK PKWY UNIT 170434, AUSTIN, TX 78717-0119
(972) 849-4000
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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