Individual
DR. JENNIFER J BLASINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 3000, COLLEGE STATION, TX 77845-8306
(979) 764-4043
(979) 694-2175
Mailing address
1602 ROCK PRAIRIE RD, SUITE 3000, COLLEGE STATION, TX 77845-8306
(979) 764-4043
(979) 694-2175
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L3243
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147518801
—
TX
01
—
160054934
MEDICARE RAILROAD
TX
01
—
8308N1
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
07/13/2006
Last updated
09/15/2008
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