Individual
BORIS R BLECHACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P0815
TX
207RG0100X
Gastroenterology Physician
50214
MN
207RG0100X
Gastroenterology Physician
Primary
P0815
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257458000
—
MN
Enumeration date
09/11/2007
Last updated
07/06/2022
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