Individual
DR. DOUGLAS SCOTT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1002 TEXAS BLVD, SUITE 401, TEXARKANA, TX 75501-5107
(903) 794-8820
(903) 794-8878
Mailing address
1002 TEXAS BLVD, SUITE 401, TEXARKANA, TX 75501-5107
(903) 794-8820
(903) 794-8878
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
L0033
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042154704
—
TX
05
—
100848130B
—
OK
05
—
140606001
—
AR
Enumeration date
10/20/2005
Last updated
11/04/2015
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