Individual
ALEX JOSEPH BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10410 MEDICAL LOOP, UNIT 3B, LAREDO, TX 78045-6612
(956) 523-8900
(956) 523-8903
Mailing address
10410 MEDICAL LOOP, UNIT 3B, LAREDO, TX 78045-6612
(956) 523-8900
(956) 523-8903
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1804
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148154106
—
TX
01
—
8P9780
BLUE CROSS
TX
01
—
L1804
LICENSE
TX
01
—
T0119526
DPS
TX
Enumeration date
11/13/2006
Last updated
03/07/2023
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