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JONATHAN BLAU MD PA NPI 1073653820


NPI Information

NPI: 1073653820
Provider Name: JONATHAN BLAU MD PA
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
1814 ROSELAND BLVD
SUITE 200
TYLER, TX
ZIP 75701
Phone: (903) 593-6500
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JONATHAN BLAU MD PA is a pain medicine physical medicine rehabilitation in Tyler, TX. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. JONATHAN BLAU MD PA NPI is 1073653820. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1814 ROSELAND BLVD
SUITE 200
TYLER, TX
ZIP 75701-234
Phone: (903) 593-6500
Fax: (903) 531-9535

The provider's authorized official is Jonathan Blau .
The authorized official title is Owner Physician and has the following contact phone number (903) 593-6500.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 7/27/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12081P2900XPhysical Medicine & RehabilitationPain MedicineJ4721TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18B2513MEDICARE ID-TYPE UNSPECIFIEDTEXAS
2F69130MEDICARE UPINTEXAS
3163743101MEDICAIDTEXAS
46264980001MEDICARE NSCTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.