Provider Demographics
NPI:1114305489
Name:BLUM, JANET (PT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BLUM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1711 HUGE OAKS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3423
Mailing Address - Country:US
Mailing Address - Phone:713-550-4006
Mailing Address - Fax:
Practice Address - Street 1:7324 SOUTHWEST FWY STE 978
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2044
Practice Address - Country:US
Practice Address - Phone:281-888-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist