Blackmon, Michael Bendele
Blackmon, Michael Bendele is an individual health care provider with primary practice located at 6124 W Parker Rd Suite 530, Plano TX 75093-8122. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Blackmon, Michael Bendele can be contacted via phone (214) 778-1075.Contact Information
Primary practice address
6124 W Parker Rd Suite 530
Plano TX 75093-8122
Phone: (214) 778-1075
Fax: (214) 778-1237
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 311912 | Louisiana |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | K0266 | Texas |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | K0266 | Texas |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01081457A | Indiana |
Profile Details
| NPI number | 1043202849 |
|---|---|
| LBN Legal business name | Blackmon, Michael Bendele |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Oct 11th, 2022 - about 2 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 | 1043202849 | NPPES |
| Louisiana | Other | 311912 | STATE LICENSE |
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