Provider Demographics
NPI:1730289695
Name:BLAZEK, ALLISON M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:BLAZEK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1740 W 27TH ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1440
Mailing Address - Country:US
Mailing Address - Phone:713-880-2311
Mailing Address - Fax:713-880-1620
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:SUITE 215
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-880-2311
Practice Address - Fax:713-880-1620
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL1273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145057902Medicaid
TX145057902Medicaid
8A1391Medicare ID - Type Unspecified