Provider Demographics
NPI:1548220106
Name:BLAU, PATRICIA DANSBY (PT PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DANSBY
Last Name:BLAU
Suffix:
Gender:F
Credentials:PT PHD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:BLAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-648-6562
Mailing Address - Fax:214-648-6285
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-648-6562
Practice Address - Fax:214-648-6285
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P88393Medicare UPIN
TX8A9715Medicare ID - Type Unspecified