Provider Demographics
NPI:1871190439
Name:JOHN, BLESSON
Entity type:Individual
Prefix:MR
First Name:BLESSON
Middle Name:
Last Name:JOHN
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 1:802 S CARANCAHUA ST APT 224
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78401-3405
Mailing Address - Country:US
Mailing Address - Phone:469-348-6158
Mailing Address - Fax:
Practice Address - Street 1:5802 SARATOGA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4252
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:888-880-9323
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA14073363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant