Individual
MR. BLAINE B. ROURKE
Active
Individual
MR. BLAINE B. ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO217686
OR
363A00000X
Physician Assistant
PA03254
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182196901
—
TX
01
—
8L5723
MEDICARE PTAN
TX
Enumeration date
07/15/2006
Last updated
04/08/2025
Update your record
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