Provider Demographics
NPI:1306243365
Name:BLAS, MONICA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:BLAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 ENCLAVE PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2577
Mailing Address - Country:US
Mailing Address - Phone:855-795-3148
Mailing Address - Fax:
Practice Address - Street 1:1330 ENCLAVE PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2577
Practice Address - Country:US
Practice Address - Phone:855-795-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46993183500000X
NY059131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist