Individual
ANA BLACKMON
Active
Individual
ANA BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
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
Update your record
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