Provider Demographics
NPI:1891041695
Name:BEST, BLAINE THOMAS (MHA, ATP)
Entity Type:Individual
Prefix:
First Name:BLAINE
Middle Name:THOMAS
Last Name:BEST
Suffix:
Gender:M
Credentials:MHA, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 STONE BR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2446
Mailing Address - Country:US
Mailing Address - Phone:830-822-3603
Mailing Address - Fax:
Practice Address - Street 1:1650 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-3832
Practice Address - Country:US
Practice Address - Phone:830-822-3603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP47840247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other