George M. Blackburn Jr. D.m.d. | |
12505 Hymeadow Dr Ste. 2 D Austin TX 78750-1867 | |
(512) 258-3627 | |
Not Available |
Full Name | George M. Blackburn Jr. D.m.d. |
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Speciality | Dentist |
Location | 12505 Hymeadow Dr, Austin, Texas |
Authorized Official Name and Position | George M. Blackburn (OWNER) |
Authorized Official Contact | 5122583627 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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George M. Blackburn Jr. D.m.d. 12505 Hymeadow Dr Ste. 2 D Austin TX 78750-1867 Ph: (512) 258-3627 | George M. Blackburn Jr. D.m.d. 12505 Hymeadow Dr Ste. 2 D Austin TX 78750-1867 Ph: (512) 258-3627 |
NPI Number | 1083995500 |
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Provider Enumeration Date | 08/30/2011 |
Last Update Date | 08/30/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083995500 | NPI | - | NPPES |
1003870601 | Other | TX | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 10496 (Texas) | Primary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |