| 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. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
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