Individual
DR. BLAISE T BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
9900 S INTERSTATE 35 STE P375, AUSTIN, TX 78748-3885
(512) 580-3006
(512) 765-9192
Mailing address
PO BOX 306393, NASHVILLE, TN 37230-6393
(615) 373-1350
(615) 221-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1298341
TX
Other
Enumeration date
08/24/2017
Last updated
09/24/2020
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