Individual
DR. NICKE THERESA BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5429 ASHBY ST, HOUSTON, TX 77005-1721
(713) 529-2405
Mailing address
5429 ASHBY ST, HOUSTON, TX 77005-1721
(713) 529-2405
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D6953
TX
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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