Provider Demographics
NPI:1992794333
Name:BLADES, CARRIE F (MD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:F
Last Name:BLADES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21214 NORTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3373
Mailing Address - Country:US
Mailing Address - Phone:832-912-3800
Mailing Address - Fax:
Practice Address - Street 1:21214 NORTHWEST FWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3373
Practice Address - Country:US
Practice Address - Phone:832-912-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1025207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH99164Medicare UPIN
TX8D7567Medicare ID - Type Unspecified