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Organization
TREPA PA
Active
Organization
TREPA PA
Active
Other names
Tomball Regional Emergency Physician Associates PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD GLEN BLASCHKE II DMD (MANAGER)
(615) 979-9453
Entity
Organization
Contact information
Practice address
605 HOLDERRIETH BLVD, TOMBALL, TX 77375-6445
(281) 401-7500
Mailing address
5400 MARYLAND WAY STE 100, BRENTWOOD, TN 37027-5048
(615) 979-9453
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
TX
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
TX
363L00000X
Nurse Practitioner
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057QC
BCBS
TX
05
—
190652101
—
TX
Enumeration date
09/10/2007
Last updated
10/13/2021
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