Doctor Name: | LAURA ELIZABETH BLAND |
NPI Number: | 1013105105 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA04731 |
Business Practice Address: | 4308 Allenbrook Dr Baytown, TX - 775213200 |
Business Phone Number: | 2814224141 |
Business Fax Number: | |
Mailing Address: | 4308 Allenbrook Dr, BAYTOWN |
State: | TX |
Postal Code: | 775213200 |
Phone Number: | 2814224141 |
Fax Number: | 2814225939 |
NPI Enumeration Date: | 10/15/2007 |
NPI Last Update Date: | 05/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA04731 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |