Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | P2098 | TX |
NPI | 1023271582 |
---|---|
Provider Name | Dr. Lauren Sasha Blieden |
First Address | Houston, TX 77030-4101 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2008 |
Last Update Date | 26/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306214301 | (05) | TX |
306214302 | CSHCN (01) | TX |