Provider Demographics
NPI:1073023131
Name:PEDRO A BLANDON MD PA
Entity Type:Organization
Organization Name:PEDRO A BLANDON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-491-4807
Mailing Address - Street 1:1250 E CLIFF DR STE 3E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4847
Mailing Address - Country:US
Mailing Address - Phone:915-626-5548
Mailing Address - Fax:915-626-5411
Practice Address - Street 1:1250 E CLIFF DR STE 3E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4847
Practice Address - Country:US
Practice Address - Phone:915-244-0598
Practice Address - Fax:888-299-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty