Provider Demographics
NPI:1003361288
Name:AZIOS, BLANCA (MD, FAAP)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:
Last Name:AZIOS
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SUGAR CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4028
Mailing Address - Country:US
Mailing Address - Phone:713-857-9784
Mailing Address - Fax:
Practice Address - Street 1:707 SUGAR CREEK BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4028
Practice Address - Country:US
Practice Address - Phone:713-857-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2349174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAA0925252OtherDEA