Individual
DR. JORGE D BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 E 6TH ST STE 202, ODESSA, TX 79761-4572
(432) 582-8757
(432) 582-8928
Mailing address
PO BOX 4123, ODESSA, TX 79760-4123
(432) 582-2277
(432) 333-2802
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
F3413
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112711004
—
TX
Enumeration date
06/12/2006
Last updated
01/05/2016
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