Organization
J. BLAKE BOLIN, M.D., P.A.
Active
Parent organization
J. BLAKE BOLIN, M.D.
Other names
J. Blake Bolin, M.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
J. BLAKE BOLIN, M.D.
Authorized official
DONNA K WARD CPC (BILLING REP)
(214) 551-5101
Entity
Organization
Contact information
Practice address
3550 PARKWOOD BLVD, STE 405, FRISCO, TX 75034-1903
(469) 287-8800
(469) 287-8801
Mailing address
3550 PARKWOOD BLVD, STE 405, FRISCO, TX 75034-1903
(469) 287-8800
(469) 287-8801
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K8014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174563043
TYPE 1 NPI
TX
Enumeration date
01/06/2008
Last updated
01/06/2008
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