Provider Demographics
NPI:1831251669
Name:PETIT-BLANC, DENIS
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:PETIT-BLANC
Suffix:
Gender:M
Credentials:
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 720739
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-0739
Mailing Address - Country:US
Mailing Address - Phone:281-575-9473
Mailing Address - Fax:713-271-7120
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:SUITE 284
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:281-575-9473
Practice Address - Fax:713-271-7120
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800051343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)