BLUE AGAVE WOUND CARE SOLUTIONS LLC (NPI# 1851869234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851869234 |
| Entity Type | Organization |
| Organization Name | BLUE AGAVE WOUND CARE SOLUTIONS LLC |
| Practice Address |
10109 Lake Creek Pkwy Unit 170434 Austin TX 78717-0119 |
| Mailing Address |
Po Box 170434 Austin TX 78717-0027 |
| Practice Telephone | 8442753822 |
| Mailing Telephone | 8442753822 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| Authorized Official Name | RICHARD CARNEY (MEMBER LLC) |
| Authorized Official Telephone | 6195686800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WH0200X |
Registered Nurse Specialization: Home Health |
Nursing Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SH0200X |
Clinical Nurse Specialist Specialization: Home Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| Y | 163WW0000X |
Registered Nurse Specialization: Wound Care |
Nursing Service Providers |
| Street Address |
10109 LAKE CREEK PKWY UNIT 170434 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78717-0119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766290 | Eva Charo | Registered Nurse | 2036 Bel Paese Bend, Leander, TX 78717 | 2020-10-06 |
| 1568940591 | Hannah Joy Winger | Registered Nurse | 15510 Ranch Road 620 North. Apt 2104, Austin, TX 78717 | 2018-08-01 |
| 1811406192 | Msh Diamondback Health Services LLC | Nurse Practitioner | 16219 Ranch Road 620, Austin, TX 78717 | 2017-09-29 |
| 1790204378 | May Paraan Harris | Nurse Practitioner | 162919 Ranch Road 620 N., Austin, TX 78717 | 2017-09-14 |
| 1386168706 | Zachary David Lewitz | Pharmacist | 14028 North Us 183, Austin, TX 78717 | 2017-07-27 |
| 1538608724 | Britex Walden Pllc | Clinic/Center | 9800 North Lake Creek Parkway, Suite # 150, Austin, TX 78717 | 2017-02-21 |
| 1639574338 | Sam's East, Inc. | Technician/Technologist | 10901 Lakeline Mall Dr., Austin, TX 78717 | 2014-10-24 |
| 1023453677 | Nw Dentistry and Orthodontics, PC | Dentist | 14028 North Us Highway 183, Suite 430, Austin, TX 78717 | 2013-05-08 |
| 1831430677 | Brian Fagan | Pharmacist | 14028 Highway 183, Austin, TX 78717 | 2013-03-04 |
| 1891036703 | Paul Jeffrey Marchioni | Pharmacist | 14028 North Us Hwy. 183, Austin, TX 78717 | 2013-03-04 |
| Find all providers in zip 78717 | ||||
| Taxonomy Code | 163WW0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Wound Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881923118 | Nautilus Health Care Group Pa PC | Registered Nurse | 211 E 7th St, Ste 620, Austin, TX 78701-3218 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710991 | Imayarze Limonta-cordero | Registered Nurse | 14119 Sandhill Crane Dr, Houston, TX 77044-4413 | 2020-11-05 |
| 1508463852 | Bio Energetic LLC | Registered Nurse | 4710 Vista Rd, Pasadena, TX 77505-2810 | 2020-10-08 |
| 1114548203 | Joni Curry Barone | Registered Nurse | 16236 County Road 4197, Lindale, TX 75771-6343 | 2020-04-30 |
| 1528692134 | Cluster Consult Pllc | Registered Nurse | 3502 Stirling St, Wichita Falls, TX 76310-1760 | 2020-02-24 |
| 1770054207 | Aaron Penny | Registered Nurse | 2414 Weatherby Dr, Mesquite, TX 75181-1060 | 2018-12-10 |
| 1831672062 | Lonestar Wound Care and Hyperbarics LLC | Registered Nurse | 6161 N State Highway 161 Ste 305, Irving, TX 75038-2220 | 2018-09-13 |
| 1174009690 | Blue Agave Solutions | Registered Nurse | 15825 Carlton Oaks Dr, Fort Worth, TX 76177-2162 | 2018-07-17 |
| 1497245732 | Elizabeth Ann Shelton | Registered Nurse | 15121 Saddle Ridge Cir, Terrell, TX 75160-1003 | 2018-05-11 |
| 1790289734 | Lloyd Oghogho | Registered Nurse | 17630 Manchester Point Ln, Richmond, TX 77407-2091 | 2018-03-23 |
| 1285047969 | Precision Wound Care Services, LLC | Registered Nurse | 10617 Winding Passage Way, Fort Worth, TX 76131-3991 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.