Provider Demographics
NPI:1699356790
Name:BLEM, ERIC JOSHUA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSHUA
Last Name:BLEM
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4711
Mailing Address - Country:US
Mailing Address - Phone:210-892-3811
Mailing Address - Fax:
Practice Address - Street 1:818 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4711
Practice Address - Country:US
Practice Address - Phone:210-892-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35670225100000X
TX1325759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty