Blackmon, Alice T

Blackmon, Alice T is an individual health care provider with primary practice located at 7323 Marbach Rd Ste 104 , San Antonio TX 78227-1905. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Blackmon, Alice T can be contacted via phone (210) 674-0257.

Contact Information

Primary practice address
7323 Marbach Rd Ste 104 San Antonio TX 78227-1905
Phone: (210) 674-0257
Fax: (210) 369-9064
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP108315 Texas

Profile Details

NPI number 1265413264
LBN Legal business name Blackmon, Alice T
Credentials PNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Feb 8th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265413264 NPPES
Texas Other 00295N AFFILIATED GROUP MEDICARE#
Texas Other 1265413264 AFFILIATED GROUP MEDICARE#
Texas Other 363LP0200X AFFILIATED GROUP MEDICARE#
Texas Other AP108315 AFFILIATED GROUP MEDICARE#
Texas Other 1508813494 AFFILIATED GROUP MEDICARE#

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