Individual
DR. BLYTHE KELLEY GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6565 FANNIN ST, B490, HOUSTON, TX 77030-2703
(713) 441-3496
Mailing address
PO BOX 4701, HOUSTON, TX 77210-4701
(800) 288-8325
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
BP1-0022075
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N3686
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2790078923
MYUTMB 2790078923-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
03/01/2025
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