| Channa Blakely, | |
|
301 University Blvd, Galveston, TX 77555-0534 | |
| (409) 772-0531 | |
| Not Available |
| Full Name | Channa Blakely |
|---|---|
| Gender | Female |
| Speciality | Vascular Surgery |
| Experience | 6 Years |
| Location | 301 University Blvd, Galveston, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275190084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | U9211 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Texas Medical Branch Galveston | Galveston, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Utmb Faculty Group Practice | 3375456734 | 948 |
| Entity Name | Utmb Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942241146 PECOS PAC ID: 3375456734 Enrollment ID: O20031112000438 |
| Mailing Address | Practice Location Address |
|---|---|
| Channa Blakely, 301 University Blvd, Galveston, TX 77555-0534 Ph: (409) 772-0531 | Channa Blakely, 301 University Blvd, Galveston, TX 77555-0534 Ph: (409) 772-0531 |
Dr. Jennifer Ann Minneman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 301 University Blvd, Galveston, TX 77555 Phone: 409-772-1011 Fax: 409-772-4456 | |
Danielle Rogan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 301 University Blvd, Galveston, TX 77555 Phone: 409-772-8119 | |
Dr. Ravi Radhakrishnan, MD Surgery Medicare: Medicare Enrolled Practice Location: 301 University Blvd., Galveston, TX 77555 Phone: 409-772-5666 Fax: 409-772-4253 | |
Mohammadali Mohajel Shoja, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 301 University Blvd, Galveston, TX 77555 Phone: 409-772-1369 | |
Joseph Patrick Kearney Jr., MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 301 University Blvd, Rt 1022, Galveston, TX 77555 Phone: 409-772-2222 | |
Carlos Gabriel Chavez, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 301 University Blvd, Galveston, TX 77555 Phone: 409-772-0531 Fax: 409-772-0557 | |
Juliano Lentz Carvalho, MD Surgery Medicare: Medicare Enrolled Practice Location: 301 University Blvd, Galveston, TX 77555 Phone: 409-772-0531 |