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Contact Information

JONATHAN BLAU MD PA
1814 ROSELAND BLVD
SUITE 200
TYLER, TX75701-4234
 Phone: 903-593-6500
 Fax: 903-531-9535
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for JONATHAN BLAU MD PA · (Female)

NPI Number 1073653820
Status Active
Credentials
Entity Individual
Enumeration date 02/08/2007
Last updated 07/27/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # J4721
  • TX Medicaid 163743101
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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