Individual
BLAKE ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4418
Mailing address
1600 PROVIDENCE DR, WACO, TX 76707-2261
(254) 313-4418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
V3235
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2023
Last updated
03/27/2025
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