Individual
DR. ROBERT VAN BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
719 W COKE RD, SUITE 1, BLDG 1, WINNSBORO, TX 75494-3011
(903) 342-3710
(903) 342-3709
Mailing address
PO BOX 69, WINNSBORO, TX 75494-0069
(903) 342-3710
(903) 342-3709
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H5842
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10724731
CAQH ID
TX
05
—
117273
—
TX
Enumeration date
10/13/2006
Last updated
07/09/2007
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