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General NPI Number Information
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NPI Number | 1831240738
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Entity Type | Individual
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Provider Name | JEFFERY LOWELL BLUME, D.D.S. DDS
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17350 STATE HIGHWAY 249 STE 340
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City | HOUSTON
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State | TX
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Zip | 77064-1139
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Country | US
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Telephone | 281-890-0095
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Fax | 281-890-7550
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Provider Business Mailing Address
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Address Line | 17350 TEXAS HWY. 249, SUITE #340
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City | HOUSTON
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State | TX
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Zip | 77064-1139
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Country | US
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Telephone | 281-890-0095
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Fax | 281-890-7550
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 15386
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License Number State | TX
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