# JONATHAN BLAU MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073653820
- **Authorized official:** DR. JONATHAN BLAU MD (OWNER PHYSICIAN)
- **Authorized official phone:** (903) 593-6500

## Contact information

- **Practice address:** 1814 ROSELAND BLVD, SUITE 200, TYLER, TX 75701-4234
- **Practice address phone:** (903) 593-6500
- **Practice address fax:** (903) 531-9535
- **Mailing address:** PO BOX 6547, TYLER, TX 75711-6547
- **Mailing address phone:** (903) 593-6500
- **Mailing address fax:** (903) 531-9535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | J4721 | TX | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 07/27/2010