Provider Demographics
NPI:1013999648
Name:BLANCO-QUANT, RONALD E (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:BLANCO-QUANT
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 1:1116 E.8TH
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4204
Mailing Address - Country:US
Mailing Address - Phone:956-969-0999
Mailing Address - Fax:956-968-9932
Practice Address - Street 1:1116 E.8TH
Practice Address - Street 2:SUITE #2
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4204
Practice Address - Country:US
Practice Address - Phone:956-969-0999
Practice Address - Fax:956-968-9932
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1594174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J10JMedicare PIN