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Contact Information

BLUE AGAVE WOUND CARE SOLUTIONS LLC
10109 LAKE CREEK PKWY UNIT 170434
AUSTIN, TX78717-0119
 Phone: 844-275-3822
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Wound Care

163WW0000X
 

Home Health

364SH0200X 89 Certified Clinical Nurse Specialist
 

Home Health

163WH0200X
 

Home Health Aide

374U00000X
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BLUE AGAVE WOUND CARE SOLUTIONS LLC · (Female)

NPI # 1851869234
Status Active
Credentials
Entity Individual
Enumeration date 11/05/2018
Last updated 11/05/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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