MEDICARE: MRS. LIZBETH SANTANA-BLAISE NP

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	363LA2200X	Adult Health Nurse Practitioner	AP119108	TX
2	363LA2200X	Adult Health Nurse Practitioner	654463	TX

General Provider Information

NPI Number	:	1558672931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LIZBETH SANTANA-BLAISE NP

Provider Business Mailing Address
First Line	:	5050 CRENSHAW
Second Line	:	#200
City	:	PASADENA
State	:	TX
Zip	:	77505-3139
Country	:	US
Telephone Number	:	281-998-2488
Fax Number	:	281-998-7711

Provider Business Practice Location Address
First Line	:	2240 GULF FWY S STE 2.110
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-5143
Country	:	US
Telephone Number	:	832-505-1600
Fax Number	:	281-309-0147

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

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	03/23/2026

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