Individual
KELLY KEUNEKE BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 BAYLOR PLZ, BCM610, HOUSTON, TX 77030-3411
(832) 826-7315
Mailing address
6301 ALMEDA RD, APT 615, HOUSTON, TX 77021
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
BP10042984
TX
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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