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General NPI Number Information
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NPI Number | 1548268691
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Entity Type | Individual
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Provider Name | PAMELA Y BLAKE MD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 1801 NORTH LOOP W STE 45
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City | HOUSTON
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State | TX
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Zip | 77008-1444
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Country | US
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Telephone | 713-426-3337
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Fax | 713-861-4093
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Provider Business Mailing Address
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Address Line | 1631 NORTH LOOP W STE 460
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City | HOUSTON
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State | TX
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Zip | 77008-1528
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Country | US
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Telephone | 713-426-3337
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Fax | 713-861-4093
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | M5059
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License Number State | TX
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