| Organization Name: | BLUEBONNET DURABLE MEDICAL EQUIPMENT & SUPPLIES LLC |
| NPI Number: | 1154374528 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OMAR CANALES (OWNER) |
| Mailing Address: | 507 Grant Street Ste 1 Roma |
| State: | TX US |
| Postal Code: | 78584 |
| Phone Number: | 9568491044 |
| Fax Number: | 9568497455 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 0070690 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |