Individual
DR. JOHN ANTHONY BLUE STAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 WILFORD HALL LOOP, LACKLAND AFB, TX 78236-5638
(210) 292-7361
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-7361
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
593
WY
Other
Enumeration date
03/26/2014
Last updated
09/13/2020
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