Individual
EDDIE BLAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 690, FORT WORTH, TX 76104-2133
(817) 761-7740
(817) 761-7742
Mailing address
1325 PENNSYLVANIA AVE STE 690, FORT WORTH, TX 76104-2133
(314) 251-6440
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036170087
IL
208600000X
Surgery Physician
43923-20
WI
208600000X
Surgery Physician
67923
TN
208600000X
Surgery Physician
V8108
TX
2086S0102X
Surgical Critical Care Physician
036170087
IL
2086S0102X
Surgical Critical Care Physician
2024010643
MO
2086S0102X
Surgical Critical Care Physician
43923-20
WI
2086S0102X
Surgical Critical Care Physician
Primary
V8108
TX
Other
Enumeration date
05/23/2014
Last updated
08/14/2025
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