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Individual

JOHN BLEWETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
9503 ASHTON RDG, AUSTIN, TX 78750-3637
(512) 258-0424

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E9545
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
E9545
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134989607
TX
05
134989609
TX
Enumeration date
05/05/2006
Last updated
05/11/2010
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