Individual
MISS TAMRIA DENISE BLACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
208 OAK DR S, 400A, LAKE JACKSON, TX 77566-5790
(979) 285-2900
(979) 285-2904
Mailing address
208 OAK DR S, 400A, LAKE JACKSON, TX 77566-5790
(979) 285-2900
(979) 285-2904
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
715129
TX
Other
Enumeration date
02/24/2012
Last updated
07/25/2012
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