Provider Demographics
NPI:1134394752
Name:ALLISON BLAZEK MD PA
Entity type:Organization
Organization Name:ALLISON BLAZEK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAZEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-978-0395
Mailing Address - Street 1:2310 RUTLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2556
Mailing Address - Country:US
Mailing Address - Phone:713-880-2311
Mailing Address - Fax:713-880-1620
Practice Address - Street 1:2310 RUTLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2556
Practice Address - Country:US
Practice Address - Phone:713-880-2311
Practice Address - Fax:713-880-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty