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Individual

ALICE T BLACKMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP-C

Contact information

Practice address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 645-4305
(210) 673-1850
Mailing address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 674-0257
(210) 369-9064

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP108315
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265413264
ALICE BLACKMON, PNP-C NPI#
TX
01
1508813494
GROUP PRACTICE/BILLING NPI#
TX
01
193200000X
GRP TAXONOMY
TX
01
363LP0200X
INDIVIDUAL TAXONOMY
TX
01
AP108315
LICENSE
TX
Enumeration date
11/08/2005
Last updated
03/09/2026
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