Individual
DAVID BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
306 HOSPITAL DR, CORSICANA, TX 75110
(713) 515-7795
Mailing address
6524 WAKEFOREST AVE, HOUSTON, TX 77005-3954
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
F8411
TX
2085R0203X
Therapeutic Radiology Physician
F8411
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038123801
—
TX
Enumeration date
05/23/2005
Last updated
06/26/2018
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