Provider Demographics
NPI:1902528169
Name:BLOMKER, EHRON KATHLEEN
Entity type:Individual
Prefix:
First Name:EHRON
Middle Name:KATHLEEN
Last Name:BLOMKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12303 LESLIE RD
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4683
Mailing Address - Country:US
Mailing Address - Phone:210-397-8050
Mailing Address - Fax:210-695-4810
Practice Address - Street 1:12303 LESLIE RD
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4683
Practice Address - Country:US
Practice Address - Phone:210-397-8050
Practice Address - Fax:210-695-4810
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist