Healthcare Provider Details

I. General information

NPI: 1164304549
Provider Name (Legal Business Name): YVETTE CHEREE BLAKEMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3307 CHADINGTON LN
SPRING TX
77388-2996
US

IV. Provider business mailing address

3307 CHADINGTON LN
SPRING TX
77388-2996
US

V. Phone/Fax

Practice location:
  • Phone: 713-443-1726
  • Fax:
Mailing address:
  • Phone: 713-443-1726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA0060051743
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: