Organization
BLACKLAND PRAIRIE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA RODRIGUEZ (OWNER)
(210) 262-0328
Entity
Organization
Contact information
Practice address
9330 VALLEY GATE, SAN ANTONIO, TX 78250-5773
(210) 262-0328
Mailing address
9330 VALLEY GATE, SAN ANTONIO, TX 78250-5773
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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