Individual
ANDREW J BLANKENAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4400 TEASLEY LN, SUITE 200, DENTON, TX 76210-3403
(940) 382-9898
(940) 383-3815
Mailing address
6 FOX HOLLOW RUN, SHADY SHORES, TX 76208-5741
(940) 726-6165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J3744
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3250406
BLUELINK
TX
01
—
75-2592653
TAX ID
TX
01
—
83Y900
BCBS
TX
01
—
J3744
LICENSE
TX
Enumeration date
09/16/2006
Last updated
03/07/2023
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