Provider Demographics
NPI:1508692500
Name:BLOODWORTH, ASHLAN (CSFA)
Entity type:Individual
Prefix:
First Name:ASHLAN
Middle Name:
Last Name:BLOODWORTH
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2144
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77574-2144
Mailing Address - Country:US
Mailing Address - Phone:832-932-5787
Mailing Address - Fax:832-932-5979
Practice Address - Street 1:16100 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1895
Practice Address - Country:US
Practice Address - Phone:713-413-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant