Individual
BLIA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2910 CENTER ST, DEER PARK, TX 77536-4943
(281) 479-5941
(281) 479-8459
Mailing address
2910 CENTER ST, DEER PARK, TX 77536-4943
(281) 479-5941
(281) 479-8459
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07857
TX
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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