Individual
JEFFREY S BLASICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7005 WOODWAY DR STE 101, WOODWAY, TX 76712-6160
(254) 224-8062
(254) 224-6385
Mailing address
PO BOX 16190, BELFAST, ME 04915-4056
(254) 754-0375
(254) 754-2667
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
Q6735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q6735
LICENSE
TX
Enumeration date
07/29/2011
Last updated
08/20/2024
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