Holly Akin Blanco, MD | |
8288 S Broadway Ave, Tyler, TX 75703-5262 | |
(903) 606-7060 | |
(903) 606-7025 |
Full Name | Holly Akin Blanco |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 8288 S Broadway Ave, Tyler, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598993172 | NPI | - | NPPES |
752616977028 | Other | TX | TRICARE |
752616977118 | Other | TX | TRICARE |
8DG294 | Other | TX | BCBS |
3030478801 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | P2830 (Texas) | Primary |
Entity Name | Christus Trinity Clinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
Entity Name | Mother Frances Hospital Jacksonville |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952306672 PECOS PAC ID: 5597751024 Enrollment ID: O20040421001092 |
Entity Name | Mother Frances Hospital Regional Health Care Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679578439 PECOS PAC ID: 9234025636 Enrollment ID: O20040610001042 |
Mailing Address | Practice Location Address |
---|---|
Holly Akin Blanco, MD Po Box 846098, Dallas, TX 75284-6098 Ph: (903) 324-6450 | Holly Akin Blanco, MD 8288 S Broadway Ave, Tyler, TX 75703-5262 Ph: (903) 606-7060 |
Krystal Castle, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 305 W Rusk St, Tyler, TX 75701 Phone: 903-592-7304 | |
Daniel Jun Park, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Mrs. Valerie B Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 E Richards St, Tyler, TX 75702 Phone: 903-531-9455 Fax: 903-526-3118 | |
Kristina Orey Mitchell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701 Phone: 903-596-3862 Fax: 903-590-5005 | |
Adelina G. Meadows, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Dr. Michael David Austin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St, Tyler, TX 75701 Phone: 903-594-2450 Fax: 903-939-0610 | |
James Riley Davis, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701 Phone: 903-590-5000 Fax: 903-590-5005 |