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Individual

JO ANN BLACCKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2424 WILCREST DR STE 110, HOUSTON, TX 77042-2772
(713) 666-8287
Mailing address
3927 CARTERS LAKE DR, RICHMOND, TX 77406-6973

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
463904
TX

Other

Enumeration date
10/14/2020
Last updated
10/14/2020
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