| Tanya Blenden | |
|
14001 Walden Rd Ste 700 Montgomery TX 77356-5205 | |
| (254) 289-7373 | |
| (936) 582-0145 |
| Full Name | Tanya Blenden |
|---|---|
| Speciality | Clinic/center |
| Location | 14001 Walden Rd Ste 700, Montgomery, Texas |
| Authorized Official Name and Position | Tanya Elise Blenden Devries (FOUNDER , CEO, OWNER) |
| Authorized Official Contact | 2542897373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya Blenden 14001 Walden Rd Ste 700 Montgomery TX 77356-5205 Ph: (254) 289-7373 | Tanya Blenden 14001 Walden Rd Ste 700 Montgomery TX 77356-5205 Ph: (254) 289-7373 |
| NPI Number | 1407416670 |
|---|---|
| Provider Enumeration Date | 06/19/2019 |
| Last Update Date | 02/08/2021 |
| Certification Date | 12/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407416670 | NPI | - | NPPES |
| 3268245-02 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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