Individual
OLGA PAVLOVNA BLAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036146751
IL
207L00000X
Anesthesiology Physician
17235
MS
207L00000X
Anesthesiology Physician
Primary
A86519
CA
207L00000X
Anesthesiology Physician
E4506
AR
207L00000X
Anesthesiology Physician
L9627
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
E4506
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186548713
—
TX
01
—
214881
MEDICARE MULTISPECIALTY GROUP PTAN
IL
01
—
8FW599
BCBS
TX
01
—
P01745927
RR MEDICARE
TX
Enumeration date
01/10/2006
Last updated
01/24/2023
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