Individual
BLAKE SPORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3901 STATE JAIL RD, EL PASO, TX 79938-8465
(915) 856-0046
Mailing address
3109 TUNNEL POINT WAY, EL PASO, TX 79938-5000
(210) 419-7158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13261
TX
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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