Individual
MICHAEL JONATHAN BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 VINTAGE PARK BLVD STE A, HOUSTON, TX 77070-3999
(832) 230-2861
Mailing address
130 VINTAGE PARK BLVD STE A, HOUSTON, TX 77070-3999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN1031400
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
1214260
TX
Other
Enumeration date
08/02/2024
Last updated
03/24/2026
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