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General NPI Number Information
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NPI Number | 1447240593
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Entity Type | Individual
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Provider Name | ANGEL I BLANCO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 6400 FANNIN ST STE 220
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City | HOUSTON
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State | TX
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Zip | 77030-1553
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Country | US
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Telephone | 713-704-2650
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Fax | 713-704-5710
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Provider Business Mailing Address
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Address Line | 6400 FANNIN ST STE 2070
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City | HOUSTON
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State | TX
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Zip | 77030-1541
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Country | US
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Telephone | 713-486-7747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | M1026
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License Number State | TX
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