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Individual

DR. BLAKE R CHRISTENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
512 HEWITT DR, HEWITT, TX 76643-0296
(254) 666-2292
Mailing address
PO BOX 296, HEWITT, TX 76643-0296
(254) 666-2292

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2919
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093080202
TX
Enumeration date
10/04/2005
Last updated
02/07/2013
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