Individual
ANN PATRICE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 HOUSTON STREET, CASTROVILLE, TX 78009
(830) 538-3550
(830) 538-3553
Mailing address
1501 HOUSTON STREET, CASTROVILLE, TX 78009
(830) 538-3550
(830) 538-3553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G9322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121122905
—
TX
Enumeration date
06/02/2006
Last updated
04/09/2018
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