Provider Demographics
NPI:1790748309
Name:BLOSS, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BLOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FANNIN ST
Mailing Address - Street 2:STE 3200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-796-1600
Mailing Address - Fax:713-796-0397
Practice Address - Street 1:7900 FANNIN ST
Practice Address - Street 2:STE 3200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-796-1600
Practice Address - Fax:713-796-0397
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE78292086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110342604Medicaid
TXP00749589OtherRAILROAD MEDICARE
TX112545202Medicaid
TXP00749589OtherRAILROAD MEDICARE