Provider Demographics
NPI:1255886685
Name:EPIOM TECHNOLOGIST
Entity type:Organization
Organization Name:EPIOM TECHNOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-226-3420
Mailing Address - Street 1:18756 STONE OAK PKWY
Mailing Address - Street 2:248
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4790
Mailing Address - Country:US
Mailing Address - Phone:914-226-3420
Mailing Address - Fax:
Practice Address - Street 1:18756 STONE OAK PKWY
Practice Address - Street 2:248
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4790
Practice Address - Country:US
Practice Address - Phone:914-226-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPIOM, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty