Organization
BLUEJACK SURGICAL AFFILIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER JOHN BROCK (MANAGING PARTNER)
(972) 979-6222
Entity
Organization
Contact information
Practice address
1202 E ARAPAHO RD STE 122, RICHARDSON, TX 75081-2400
(469) 250-4422
(469) 250-7068
Mailing address
1202 E ARAPAHO RD STE 122, RICHARDSON, TX 75081-2400
(469) 250-4422
(469) 250-7068
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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