Individual
DR. ANGEL I BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7121 S PADRE ISLAND DR, SUITE 102-101,119, CORPUS CHRISTI, TX 78412-4938
(361) 696-6000
(361) 992-4120
Mailing address
PO BOX 676638, DALLAS, TX 75267-6638
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
M1026
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447240593
BLUE CROSS BLUE SHIELD
TX
05
—
166102702
—
TX
05
—
166102703
—
TX
01
—
166102704
CSHCN (MEDICAID)
TX
01
—
P00859678
MEDICARE RAILROAD
TX
Enumeration date
10/28/2005
Last updated
03/26/2026
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