# BLACKLAND PRAIRIE MEDICAL PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902359821
- **Authorized official:** EMMA RODRIGUEZ (OWNER)
- **Authorized official phone:** (210) 262-0328

## Contact information

- **Practice address:** 9330 VALLEY GATE, SAN ANTONIO, TX 78250-5773
- **Practice address phone:** (210) 262-0328
- **Mailing address:** 9330 VALLEY GATE, SAN ANTONIO, TX 78250-5773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2016
- **Last updated:** 07/27/2016