Individual
DR. DAVID R BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2-4089
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000K72N6
—
TX
Enumeration date
07/25/2006
Last updated
12/06/2021
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