Provider Demographics
NPI:1235566308
Name:BLANCHARD, SUSANNA REICH (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:REICH
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:ADELE
Other - Last Name:REICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:6565 DE MOSS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-5099
Mailing Address - Country:US
Mailing Address - Phone:832-548-5000
Mailing Address - Fax:281-628-2051
Practice Address - Street 1:6565 DE MOSS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5099
Practice Address - Country:US
Practice Address - Phone:832-548-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124406363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics