Individual
KAITLIN JANANN BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7 MEDICAL PKWY, DALLAS, TX 75234-7829
(903) 563-4146
Mailing address
14902 PRESTON RD STE 404-813, DALLAS, TX 75254-9105
(903) 563-4146
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1006425
TX
363L00000X
Nurse Practitioner
Primary
1006425
TX
363LF0000X
Family Nurse Practitioner
1006425
TX
Other
Enumeration date
04/14/2021
Last updated
01/22/2024
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