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Individual
ROBERT BLALOCK
Active
Individual
ROBERT BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J1103
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
J1103
TX
2080P0006X
Developmental - Behavioral Pediatrics Physician
J1103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P081461N4
—
TX
Enumeration date
09/24/2009
Last updated
09/24/2009
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