Provider Demographics
NPI:1689000200
Name:CALDAS, BLANCA C
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:C
Last Name:CALDAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 N STORY RD
Mailing Address - Street 2:STE 101
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-6764
Mailing Address - Country:US
Mailing Address - Phone:214-929-0795
Mailing Address - Fax:
Practice Address - Street 1:612 N STORY RD
Practice Address - Street 2:STE 101
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-6764
Practice Address - Country:US
Practice Address - Phone:214-929-0795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath