Individual
DR. KATHERINE RYAN BLAKELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6606 LYNDON B JOHNSON FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H7905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X167
MEDICARE ID TYPE PIN
TX
Enumeration date
04/11/2006
Last updated
05/08/2020
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