Individual
BROOKS M BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1800 MORMON MILL RD, STE A6, MARBLE FALLS, TX 78654-4175
(830) 798-8000
(830) 798-8120
Mailing address
1800 MORMON MILL RD, STE A6, MARBLE FALLS, TX 78654-4175
(830) 798-8000
(830) 798-8120
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
L4187
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0041KC
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/13/2006
Last updated
07/08/2007
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