Provider Demographics
NPI:1891392437
Name:BLUM HEALTH PLLC
Entity Type:Organization
Organization Name:BLUM HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCANTAR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:915-490-7491
Mailing Address - Street 1:11988 PASEO DEL REY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3787
Mailing Address - Country:US
Mailing Address - Phone:915-490-7491
Mailing Address - Fax:
Practice Address - Street 1:600 SUNLAND PARK DR STE 1-400
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5135
Practice Address - Country:US
Practice Address - Phone:915-490-7491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417346693OtherNPI
TX1811367220OtherNPI