Blacklock, Jerry
Blacklock, Jerry is an individual health care provider with primary practice located at 6560 Fannin St Suite 900, Houston TX 77030-2761. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Blacklock, Jerry can be contacted via phone (713) 441-3800.Contact Information
Primary practice address
6560 Fannin St Suite 900
Houston TX 77030-2761
Phone: (713) 441-3800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | G9066 | Texas |
Profile Details
| NPI number | 1124053392 |
|---|---|
| LBN Legal business name | Blacklock, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jan 24th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124053392 | NPPES |
| Texas | Other | 8GD848 | BCBS |
| Texas | Other | P00216844 | BCBS |
| Texas | Other | 8EA863 | BCBS |
| Texas | Other | P01331480 | BCBS |
| Texas | Other | 8R9781 | BCBS |
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