Provider Demographics
NPI:1437903051
Name:CLEMONS BIANCHINI, BRIANA ELISE (DPM)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:ELISE
Last Name:CLEMONS BIANCHINI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HIGH HILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-4488
Mailing Address - Country:US
Mailing Address - Phone:979-966-2804
Mailing Address - Fax:
Practice Address - Street 1:1917 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3994
Practice Address - Country:US
Practice Address - Phone:832-991-5313
Practice Address - Fax:281-783-2115
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program