Carl J Blackburn Od LLC
Optometrist in Houston, TX. Organization (NPI-2).
NPI number1124375498
StatusActive
Last updated in NPPESMar 19, 2013
Details
- NPI
- 1124375498
- Entity type
- Organization (NPI-2)
- Legal business name
- Carl J Blackburn Od LLC
- Organization subpart
- No
- Enumeration date
- Aug 6, 2012
- Last updated
- Mar 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 1771TG | TX | Yes |
Other names
- Family Eye Clinic Of Houston, LLC (Doing Business As)
Practice location
5655 E Sam Houston Pkwy NHouston, TX 77015-3250
Phone 713-450-4484 · Fax 713-450-4424
Mailing address
7619 Dolphin Arc DrHumble, TX 77346-8199
Phone 281-852-4440
Authorized official
Carl Joseph Blackburn
Owner / Sole Member
2818524440
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