Individual
CARL JOSEPH BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5655 E SAM HOUSTON PKWY N, A, HOUSTON, TX 77015-3250
(713) 450-4484
(713) 450-4424
Mailing address
7619 DOLPHIN ARC DR, HUMBLE, TX 77346-8199
(713) 450-4484
(713) 450-4424
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1771TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158706501
—
TX
Enumeration date
06/28/2006
Last updated
07/08/2007
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