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Organization
THETA CARE PLLC
Active
Organization
THETA CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BLACKMON (MD)
(972) 318-9731
Entity
Organization
Contact information
Practice address
2410 LUNA RD STE 252, CARROLLTON, TX 75006-6538
(972) 318-9731
(877) 360-0326
Mailing address
2410 LUNA RD STE 248, CARROLLTON, TX 75006-6578
(972) 318-9731
(877) 360-0326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
Other
Enumeration date
07/11/2024
Last updated
08/06/2024
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