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Alice T Blackmon, PNP-C
Pediatric Nurse Practitioner in San Antonio, Texas
NPI 1265413264

Alice T Blackmon is a Pediatric Nurse Practitioner based in San Antonio, TX and is specialized in Pediatrics. Alice T Blackmon practices in San Antonio, TX and has the professional credentials of PNP-C. The NPI Number for Alice T Blackmon is 1265413264 and holds a License No. AP108315 (Texas).

The current practice location address for Alice T Blackmon is 7323 Marbach Rd Ste 104, San Antonio, TX and can be reached out via phone at 210-674-0257 and via fax at 210-369-9064. You can also correspond with Alice T Blackmon through the mailing address at 7323 MARBACH RD STE 104, SAN ANTONIO, TX - 78227-1905 (mailing address contact number: 210-674-0257).

Location: 7323 Marbach Rd Ste 104, San Antonio, TX, 78227-1905
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Provider Profile Details
NPI Number
1265413264
Provider Name
Alice T Blackmon
Credential
PNP-C
Provider Entity Type
Individual
Gender
Female
Address
7323 Marbach Rd Ste 104, San Antonio, TX, 78227-1905
Phone Number
210-674-0257
Fax Number
210-369-9064
Provider Enumeration Date
11/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00295N 01 TX AFFILIATED GROUP MEDICARE#
1265413264 01 TX NPI#
363LP0200X 01 TX TAXONOMY / NP-C PEDIATRICS
AP108315 01 TX LICENSE
1508813494 01 TX AFFILIATED GROUP NPI#
institution
Provider Business Practice Location Address Details
Address
7323 Marbach Rd Ste 104
City
State
Zip
78227-1905
Phone Number
210-674-0257
Fax Number
210-369-9064
person
Provider Business Mailing Address Details
Address
7323 Marbach Rd Ste 104
City
State
Zip
78227-1905
Phone Number
210-674-0257
Fax Number
210-369-9064
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
AP108315 (Texas)
Definition
Definition to come...
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