MEDICARE: DR. MONICA BLAS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS46993	FL
2	183500000X	Pharmacist	059131	NY

General Provider Information

NPI Number	:	1306243365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA BLAS PHARMD

Provider Business Mailing Address
First Line	:	1330 ENCLAVE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-2577
Country	:	US
Telephone Number	:	855-795-3148
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 ENCLAVE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-2577
Country	:	US
Telephone Number	:	855-795-3148
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2014
Last Update Date	:	05/23/2016

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Directions to “ DR. MONICA BLAS PHARMD” Practice Location

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