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Individual

DR. ROBERT CHANDLER BLEDSOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1600 W COLLEGE ST STE 380, GRAPEVINE, TX 76051-3583
(817) 481-0868
(817) 481-1378
Mailing address
1600 W COLLEGE ST STE 380, GRAPEVINE, TX 76051-3583
(817) 481-0868
(817) 481-1378

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G4836
TX
207YS0123X
Facial Plastic Surgery Physician
Primary
G4836
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
89911Z
BCBS PROVIDER ID
TX
Enumeration date
11/14/2006
Last updated
05/11/2023
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