Individual
BLAKE WILLIAM BOELENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11500 STATE HIGHWAY 121 STE 510, FRISCO, TX 75035-9348
(469) 200-4093
(469) 200-4079
Mailing address
11500 STATE HIGHWAY 121 STE 930, FRISCO, TX 75035-9347
(469) 200-4093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14195
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2019
Last updated
02/17/2026
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