Provider Demographics
NPI:1821280009
Name:BLAVIER, JULIE LANE (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LANE
Last Name:BLAVIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 OLD JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-7521
Mailing Address - Country:US
Mailing Address - Phone:903-939-2578
Mailing Address - Fax:903-939-2579
Practice Address - Street 1:16623 FM 2493
Practice Address - Street 2:STE. B
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-7904
Practice Address - Country:US
Practice Address - Phone:903-939-2578
Practice Address - Fax:903-939-2579
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor