Individual
BLAINE JENAE EUBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 N BRAZOS ST, WHITNEY, TX 76692-2010
(254) 694-3621
Mailing address
1314 N BRAZOS ST, WHITNEY, TX 76692-2010
(254) 694-3621
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12255
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
09/20/2018
Last updated
09/18/2019
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