Organization
ADVANCED OBGYN CARE OF SOUTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD B BLACKMAN JR. MD (OWNER)
(830) 769-3970
Entity
Organization
Contact information
Practice address
1901 HWY 97 E, STE 230, JOURDANTON, TX 78026
(830) 769-3970
(830) 769-3978
Mailing address
1901 HWY 97 E, STE 230, JOURDANTON, TX 78026
(830) 769-3970
(830) 769-3978
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M0326
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8D1909
MEDICARE
TX
Enumeration date
02/13/2007
Last updated
01/24/2008
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