Individual
BIANCA BLACKSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 WONDER WORLD DR STE 200, SAN MARCOS, TX 78666-7502
(512) 754-8676
(512) 371-6891
Mailing address
1700 E SAUNDERS ST, LAREDO, TX 78041-5474
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1140411
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
819527
TX
Other
Enumeration date
09/14/2023
Last updated
08/12/2025
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