Douglas Oliver Blackard, MS, MHA, LAT, CMPE
Specialist/Technologist, Athletic Trainer in Pearland, TX. Individual provider (NPI-1).
NPI number1184754475
StatusActive
Last updated in NPPESDec 15, 2019
Details
- NPI
- 1184754475
- Entity type
- Individual (NPI-1)
- Name
- Mr. Douglas Oliver Blackard
- Credential
- MS, MHA, LAT, CMPE
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 6, 2007
- Certification date
- Dec 15, 2019
- Last updated
- Dec 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | TX | Yes |
Practice location
3618 Garrettsville DrPearland, TX 77584-4984
Phone 281-412-2769
Mailing address
3618 Garrettsville DrPearland, TX 77584-4984
Phone 281-412-2769
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