NPIMap

Organization Active NPI

Trepa PA

  • Emergency Medicine Physician
  • Tomball, TX
National Provider Identifier
1063607398
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TREPA PA
Practice address
605 Holderrieth Blvd
Tomball, TX 77375-6445
Phone
(281) 401-7500
NPI assigned
Sep 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Donald Glen Blaschke II, DMD
Title
Manager
Phone
(615) 979-9453

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X TX Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X TX
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X TX

Addresses

Primary practice location

605 Holderrieth Blvd
Tomball, TX 77375-6445

Mailing address

5400 Maryland Way Ste 100
Brentwood, TN 37027-5048
Phone (615) 979-9453

Other practice location 1

5400 Maryland Way Ste 100
Brentwood, TN 37027-5048
Phone (615) 979-9453

Other identifiers 2

IdentifierTypeStateIssuer
0057QCOtherTXBCBS
190652101MedicaidTX

Other names 1

  • Tomball Regional Emergency Physician Associates PA Doing business as

National Provider Directory

National Provider Directory

Locations

5400 Maryland Way
Ste 100
Brentwood, TN 37027
Phone (615) 661-5698

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1063607398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 MARYLAND WAY STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275048",
            "telephone_number": "615-979-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 HOLDERRIETH BLVD",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756445",
            "telephone_number": "281-401-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Maryland Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370275048",
            "country_code": "US",
            "telephone_number": "615-979-9453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TREPA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "BLASCHKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-979-9453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0057QC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190652101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tomball Regional Emergency Physician Associates PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tomball Regional Emergency Physician Associates PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.