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NPI Code Detail

MEDICARE: DR. PAMELA Y BLAKE MD

MEDICARE:  DR. PAMELA Y BLAKE  MD
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
12084N0400XNeurology PhysicianM5059TX

General Provider Information

NPI Number : 1548268691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAMELA Y BLAKE MD
Provider Business Mailing Address
First Line : 1631 NORTH LOOP W
Second Line : STE 460
City : HOUSTON
State : TX
Zip : 77008-1528
Country : US
Telephone Number : 713-426-3337
Fax Number : 713-861-4093
Provider Business Practice Location Address
First Line : 1801 NORTH LOOP W
Second Line : STE 45
City : HOUSTON
State : TX
Zip : 77008-1444
Country : US
Telephone Number : 713-426-3337
Fax Number : 713-861-4093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 05/23/2012

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Directions to “ DR. PAMELA Y BLAKE MD” Practice Location

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