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Individual

DR. MICHAEL L. BLACKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
425 HOLDERRIETH BLVD STE 208, TOMBALL, TX 77375-4552
(281) 357-5515
(281) 255-3440
Mailing address
425 HOLDERRIETH BLVD STE 208, TOMBALL, TX 77375-4552
(281) 357-5515
(281) 255-3440

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
J3695
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103453003
TX
Enumeration date
04/11/2006
Last updated
05/06/2025
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