Individual
BLAKE LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N CAPITAL OF TEXAS HWY BLDG 6-125, AUSTIN, TX 78746-3329
(855) 481-8375
Mailing address
701 S CAPITAL OF TEXAS HWY STE Q900, WEST LAKE HILLS, TX 78746-5263
(512) 324-6970
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP128628
TX
Other
Enumeration date
08/31/2015
Last updated
08/15/2023
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