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Aireal Blackburn
Prosthetic/Orthotic Supplier in Humble, Texas
NPI 1972389104

Aireal Blackburn is a Prosthetic/Orthotic Supplier based in Humble, TX. Aireal Blackburn practices in Humble, TX. The NPI Number for Aireal Blackburn is 1972389104 and holds a License No. (Texas).

The current practice location address for Aireal Blackburn is 8330 N Sam Houston Pkwy E Apt 9202, Humble, TX and can be reached out via phone at 901-232-2012.

Location: 8330 N Sam Houston Pkwy E Apt 9202, Humble, TX, 77396-3399
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972389104
Provider Name
Aireal Blackburn
Credential
Provider Entity Type
Individual
Gender
Female
Address
8330 N Sam Houston Pkwy E Apt 9202, Humble, TX, 77396-3399
Phone Number
901-232-2012
Fax Number
Provider Enumeration Date
09/05/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
850817523 01 TX TAX ID
institution
Provider Business Practice Location Address Details
Address
8330 N Sam Houston Pkwy E Apt 9202
City
Humble
State
Texas
Zip
77396-3399
Phone Number
901-232-2012
Fax Number
person
Provider Business Mailing Address Details
Address
8330 N Sam Houston Pkwy E Apt 9202
City
Humble
State
Texas
Zip
77396-3399
Phone Number
901-232-2012
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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