Individual
CHRIS BLACKLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATP
Contact information
Practice address
11979 STARCREST DRIVE, SAN ANTONIO, TX 78247
(210) 696-1084
Mailing address
2204 STIRRUP DR, ROUND ROCK, TX 78681
(512) 743-2644
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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