Individual
BLAIRE MICHELLE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22001 SOUTHWEST FWY STE 200, RICHMOND, TX 77469-7002
(832) 595-7700
Mailing address
3706 CROW VALLEY DR, MISSOURI CITY, TX 77459-4203
(281) 380-5158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10135
TX
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10135
PA LICENSE
TX
Enumeration date
09/21/2015
Last updated
09/24/2020
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