Individual
BLAINE PHILLIP CARMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
408 NAVARRO ST, SAN ANTONIO, TX 78205-2502
(210) 272-1741
(210) 272-1747
Mailing address
1045 CENTRAL PARKWAY NORTH, SUITE 200, SAN ANTONIO, TX 78232-5024
(210) 541-4500
(210) 541-4508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00009
TX
Other
Enumeration date
10/14/2005
Last updated
05/25/2012
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