Blackcomb Technologies Llc | |
14983 Boaz Ln Lindale TX 75771-4801 | |
(972) 896-1843 | |
Not Available |
Full Name | Blackcomb Technologies Llc |
---|---|
Speciality | Psychiatry & Neurology - Neurology |
Location | 14983 Boaz Ln, Lindale, Texas |
Authorized Official Name and Position | Mary Semich (ADMINISTRATOR) |
Authorized Official Contact | 9728961843 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Blackcomb Technologies Llc 2813 W Southlake Blvd Ste 100 Southlake TX 76092-6832 Ph: (972) 896-1843 | Blackcomb Technologies Llc 14983 Boaz Ln Lindale TX 75771-4801 Ph: (972) 896-1843 |
NPI Number | 1528780517 |
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Provider Enumeration Date | 09/15/2022 |
Last Update Date | 10/18/2022 |
Certification Date | 10/18/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528780517 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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