Dr Blayne K Street, DO is a medicare enrolled "Pediatrics" physician in Sweetwater, Texas. His current practice location is
301 Jenny George Lane, Building B, Suite 5, Sweetwater, Texas. You can reach out to his office (for appointments etc.) via phone at
(325) 219-6175.
Dr Blayne K Street is licensed to practice in Texas (license number S6314) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568811636.
Physician's Profile
| Full Name | Dr Blayne K Street |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 301 Jenny George Lane, Sweetwater, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Blayne K Street attended and graduated from in
NPI Data:
- NPI Number: 1568811636
- Provider Enumeration Date: 06/08/2016
- Last Update Date: 06/13/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Blayne K Street such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568811636 | NPI | - | NPPES |
| 426407901 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QS0010X | Family Medicine - Sports Medicine | S6314 (Texas) | Secondary |
| 208000000X | Pediatrics | S6314 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Blayne K Street is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Blayne K Street, DO
301 Jenny George Ln, Building B, Suite 5,
Sweetwater, TX 79556-7152
Ph: (325) 219-6175 | Dr Blayne K Street, DO
301 Jenny George Lane, Building B, Suite 5,
Sweetwater, TX 79556
Ph: (325) 219-6175 |
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