Blackwell, Michael L.

Blackwell, Michael L. is an sole proprietor health care provider with primary practice located at 425 Holderrieth Blvd Ste 208 , Tomball TX 77375-4552. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Blackwell, Michael L. can be contacted via phone (281) 357-5515.

Contact Information

Primary practice address
425 Holderrieth Blvd Ste 208 Tomball TX 77375-4552
Phone: (281) 357-5515
Fax: (281) 255-3440
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X J3695 Texas

Profile Details

NPI number 1528021458
LBN Legal business name Blackwell, Michael L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2006
Last updated Jan 18th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528021458 NPPES
Texas MEDICAID 103453003

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