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Individual

DR. MICHAEL MONTGOMERY BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1340 WONDER WORLD DR STE 4031, SAN MARCOS, TX 78666-7598
(512) 353-6400
Mailing address
1340 WONDER WORLD DR STE 4031, SAN MARCOS, TX 78666-7598
(512) 353-6400

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
P0551
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287444801
TX
01
P00995618
RR MEDICARE
TX
01
TXB140444
MEDICARE
TX
Enumeration date
05/24/2007
Last updated
05/12/2025
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