Individual
DR. LORRAINE DE BLANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD., DALLAS, TX 75390-9257
(214) 648-7776
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
E-5635
AR
207U00000X
Nuclear Medicine Physician
Primary
S2278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173470001
—
AR
01
—
P00636383
RAILRAOD MEDICARE
AR
Enumeration date
05/29/2007
Last updated
08/19/2019
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