Organization
BLACKCOMB TECHNOLOGIES LLC
Active
Organization
BLACKCOMB TECHNOLOGIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SEMICH (ADMINISTRATOR)
(972) 896-1843
Entity
Organization
Contact information
Practice address
14983 BOAZ LN, LINDALE, TX 75771-4801
(972) 896-1843
Mailing address
2813 W SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6832
(972) 896-1843
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
10/18/2022
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