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Individual

DR. MARIA BLAZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-6288
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
J6553
TX
207SG0203X
Clinical Molecular Genetics Physician
Primary
J6553
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122130105
TX
Enumeration date
10/17/2006
Last updated
12/03/2021
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