Healthcare Provider Details

I. General information

NPI: 1720026131
Provider Name (Legal Business Name): DANUTA SUSAN BLICHARSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 BEECHNUT ST
HOUSTON TX
77074-4302
US

IV. Provider business mailing address

7737 SOUTHWEST FWY SUITE 400
HOUSTON TX
77074-1807
US

V. Phone/Fax

Practice location:
  • Phone: 713-456-4500
  • Fax: 713-456-4186
Mailing address:
  • Phone: 713-456-4500
  • Fax: 713-456-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberF0889
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: