Doctor Name: | ROBERT JOHN BLANCO |
NPI Number: | 1316272099 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 52680-20 |
Business Practice Address: | 1200 Hermann Pressler Dr Suite Ras W-1004 Houston, TX - 770303900 |
Business Phone Number: | 7135009479 |
Business Fax Number: | 7135009442 |
Mailing Address: | 1200 Hermann Pressler Dr, Suite Ras W-1004 HOUSTON |
State: | TX |
Postal Code: | 770303900 |
Phone Number: | 7135009479 |
Fax Number: | 7135009442 |
NPI Enumeration Date: | 10/13/2009 |
NPI Last Update Date: | 11/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 52680-20 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |