Provider Demographics
NPI:1811550460
Name:MEYER, BLANCA ESTHER
Entity Type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:ESTHER
Last Name:MEYER
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 1:18306 CAMPBELLFORD DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-7987
Mailing Address - Country:US
Mailing Address - Phone:832-975-2942
Mailing Address - Fax:
Practice Address - Street 1:10480 GRANT RD STE 121
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4406
Practice Address - Country:US
Practice Address - Phone:832-975-2942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT129814225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist