Provider Demographics
NPI:1558183061
Name:BLEES, SAMUEL JAMES
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:JAMES
Last Name:BLEES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 BOGEY WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1706
Mailing Address - Country:US
Mailing Address - Phone:651-249-7264
Mailing Address - Fax:
Practice Address - Street 1:1825 BOGEY WAY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1706
Practice Address - Country:US
Practice Address - Phone:651-249-7264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital