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1861012080
BLAKE SPORER
EL PASO, TX
NPI
1861012080
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA13261)
Enumeration Date
2020-04-17
Last Update Date
2020-04-17
Business Address
BLAKE SPORER PA-C
3901 STATE JAIL RD
EL PASO, TX 79938-8465
Phone number: 915-856-0046
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Mailing Address
BLAKE SPORER PA-C
3109 TUNNEL POINT WAY
EL PASO, TX 79938-5000
Phone number: 210-419-7158
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