Provider Demographics
NPI:1770672545
Name:BLUME, CHRIS MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:MICHAEL
Last Name:BLUME
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13611 SKINNER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2797
Mailing Address - Country:US
Mailing Address - Phone:281-970-4000
Mailing Address - Fax:281-213-4105
Practice Address - Street 1:13611 SKINNER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2797
Practice Address - Country:US
Practice Address - Phone:281-970-4000
Practice Address - Fax:281-213-4105
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist