Individual
SANDRA KAY BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 S AUSTIN ST, BRENHAM, TX 77833-4557
(979) 836-1240
(979) 836-6556
Mailing address
1401 S AUSTIN ST, BRENHAM, TX 77833-4557
(979) 836-1240
(979) 836-6556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0191512601
—
TX
05
—
0191512602
—
TX
Enumeration date
02/21/2008
Last updated
02/21/2008
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