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Individual

ANA BLACKMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6560 FANNIN ST, SUITE 1950, HOUSTON, TX 77030-2761
(713) 441-4280
(713) 790-2851
Mailing address
6560 FANNIN ST, SUITE 1950, HOUSTON, TX 77030-2761
(713) 441-4280

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L2143
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8CN637
BLUE CROSS BLUE SHIELD
TX
01
8V4450
BLUE CROSS BLUE SHIELD
TX
01
P00330517
RAILROAD MEDICARE
TX
01
P00895531
RR MEDICARE
TX
Enumeration date
07/27/2005
Last updated
11/16/2017
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