Individual
JASON L. BLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1038 S FLEISHEL AVE, TYLER, TX 75701-2044
(903) 593-9474
(903) 593-9477
Mailing address
6 DOCTOR CIR, LONGVIEW, TX 75605-5050
(903) 757-3881
(903) 757-5948
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
K9734
TX
207ND0900X
Dermatopathology Physician
K9734
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1D341263701
—
TX
05
—
341263701
—
TX
Enumeration date
06/19/2006
Last updated
09/16/2021
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