Provider Demographics
NPI:1750332904
Name:BLUESTEIN, JEAN A (MD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:A
Last Name:BLUESTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7950 FLOYD CURL DR
Mailing Address - Street 2:SUITE 1009
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3919
Mailing Address - Country:US
Mailing Address - Phone:210-615-6600
Mailing Address - Fax:210-615-7676
Practice Address - Street 1:7950 FLOYD CURL DR
Practice Address - Street 2:SUITE 1009
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3919
Practice Address - Country:US
Practice Address - Phone:210-615-6600
Practice Address - Fax:210-615-7676
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8009207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120100Medicare PIN
TX00U41VMedicare PIN
TXE51559Medicare UPIN