Individual provider Active NPI

Lorenzo Gustavo Blas, M.D.

  • Neurology Physician
  • Conroe, TX
National Provider Identifier
1760698583
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
M9866 Issued in TX
Practice address
4015 Interstate 45 N Ste 110
Conroe, TX 77304-5076
Phone
(936) 270-3900
Fax
(936) 271-1584
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X M9866 TX Primary

Addresses

Primary practice location

4015 Interstate 45 N Ste 110
Conroe, TX 77304-5076

Mailing address

4015 Interstate 45 N Ste 110
Conroe, TX 77304-5076
Phone (936) 270-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080714000509 TX Practitioner - Neurology 3173696804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians

Practice addresses (Care Compare)

16605 Southwest Fwy
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 Southwest Fwy 400 Mob3
Methodist Family Medicine Group
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 SW Fwy 410
Methodist Diag Card of Houston
Sugar Land, TX 77479-3500
Phone (281) 274-0148

16811 Southwest Fwy
Suite 200
Sugar Land, TX 77479-4728
Phone (281) 690-4678

17189 I 45 S
Shenandoah, TX 77385-3320
Phone (936) 270-3662

4015 I 45
Suite 120
Conroe, TX 77304-5076
Phone (346) 356-3044

4015 I 45 N
Conroe, TX 77304-5076
Phone (936) 270-4600

4015 Ih 45
Suite 110
Conroe, TX 77304-5076
Phone (202) 507-0700

Hospital & facility affiliations

  • Home Care Select Home health agency, Conroe, TX, CCN 747095
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122
  • Houston Methodist Willowbrook Hospital Hospital, Houston, TX, CCN 450844
  • Houston Methodist Hospital Hospital, Houston, TX, CCN 450358
  • Aspire Hospital Hospital, Conroe, TX, CCN 670093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9866TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Jun 6, 2022 Accepting new patients
TMH Physician Associates PLLC CurrentSince Jun 6, 2022 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

4015 Interstate 45 N
Ste 110
Conroe, TX 77304
Phone (936) 270-3900

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: lblas363962@direct.houstonmethodist.org
  • Direct secure messaging: lblas363962@directhoustonmethodist.org
  • Direct secure messaging: lblas42223@direct.stlukeshealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1760698583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045076",
            "telephone_number": "936-270-3900",
            "fax_number": "936-271-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 INTERSTATE 45 N STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045076",
            "telephone_number": "936-270-3900",
            "fax_number": "936-271-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAS",
        "first_name": "LORENZO",
        "middle_name": "GUSTAVO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "M9866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.