Provider Information for 1487342572
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JEANETTE BLANCO LPC
Sex: Female
NPI: 1487342572
Last Updated: 2023-11-06
Certification Date: 2023-11-06
Certification Date: 2023-11-06
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1487342572 | ||||||||
| Enumeration Date | 2023-04-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6800 PARK TEN BLVD STE 200S SAN ANTONIO, TX 78213-4293 United States Phone: 210-261-1060 | Fax:210-261-1821 | ||||||||
| Primary Practice Address | 315 N SAN SABA STE 1003 SAN ANTONIO, TX 78207-3100 United States Phone: 210-261-3100 | Fax: | ||||||||
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