| Dr Charles Ebenezer Blair, PHD, RN, CS | |
| 
					1120 Nasa Pkwy 220w, Houston, TX 77058-3362  | |
| (903) 312-7268 | |
| (281) 331-4197 | 
| Full Name | Dr Charles Ebenezer Blair | 
|---|---|
| Gender | Male | 
| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 
| Location | 1120 Nasa Pkwy 220w, Houston, Texas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144433954 | NPI | - | NPPES | 
| 0443392 | Medicaid | TX | |
| NP7054 | Other | TX | BLUECROSS & BLUESHIELD PR | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | 539564 (Texas) | Primary | 
| Entity Name | On Site Counseling,inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720353048 PECOS PAC ID: 2860656808 Enrollment ID: O20120604000336  | 
| Entity Name | Health And Human Services Commission | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356414692 PECOS PAC ID: 2163795824 Enrollment ID: O20170908001058  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Charles Ebenezer Blair, PHD, RN, CS 1120 Nasa Pkwy 220w, Houston, TX 77058-3362 Ph: (903) 312-7268  | Dr Charles Ebenezer Blair, PHD, RN, CS 1120 Nasa Pkwy 220w, Houston, TX 77058-3362 Ph: (903) 312-7268  | 
Stephanie Quintero, MSN, APRN, AG CNS-BC Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 1515 Holcombe Blvd, Houston, TX 77030 Phone: 713-792-6161  | |
Amy Jean Wolford, A.P.N Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 14340 Torrey Chase Blvd, Suite 160, Houston, TX 77014 Phone: 281-580-8086 Fax: 281-580-7129  | |
Ijeoma Gladys Obijuru, PMHNP Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 16610 Cliff Vale Ct Ste 100, Houston, TX 77084 Phone: 713-575-0795 Fax: 713-357-9325  | |
Cuong Thi Thanh Phan,  Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 7401 Main St, Houston, TX 77030 Phone: 713-799-2300 Fax: 713-794-3380  | |
Margaret A. Mcmartin, CNS-P/MH-LPA Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1311 Antoine Dr Apt 283, Houston, TX 77055 Phone: 713-208-0456  | |
Paula F. Demasi, RN, CNS Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 1515 Holcombe Blvd, Houston, TX 77030 Phone: 713-792-6161  | |
Martha Wimberly Oloomi, APRN Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 2002 Holcombe Blvd, Sci/rehab/neuro Service Line, Houston, TX 77030 Phone: 281-980-0465  |