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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

NPI Number 1073653820
LBN Legal business name JONATHAN BLAU MD PA
Authorized official JONATHAN BLAU - (OWNER PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2007
Last updated 07/27/2010 - About 16 years ago
Identifiers
TX License # J4721
TX Medicaid 163743101
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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