Individual
CHANNA BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0534
(409) 772-0531
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0534
(409) 772-0531
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
U9211
TX
Other
Enumeration date
05/28/2019
Last updated
09/20/2024
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