Organization
W B CARRELL MEMORIAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM BLAIR (CHIEF EXECTUTIVE OFFICE)
(214) 220-2468
Entity
Organization
Contact information
Practice address
9301 N CENTRAL EXPY, SUITE 400, DALLAS, TX 75231-0806
(214) 220-2468
(214) 953-1210
Mailing address
9301 N CENTRAL EXPY, SUITE 400, DALLAS, TX 75231-0806
(214) 220-2468
(214) 953-1210
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00EB96
BCBS OF TEXAS
TX
05
—
094807702
—
TX
05
—
094807703
—
TX
01
—
178801100
DEPT OF LABOR
TX
Enumeration date
06/29/2006
Last updated
04/19/2013
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