Dr. Charles Leonard Blankenship Jr., M.D.
Surgery in Texarkana, TX. Individual provider (NPI-1).
NPI number1497717060
StatusActive
Last updated in NPPESApr 29, 2015
Details
- NPI
- 1497717060
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles Leonard Blankenship Jr.
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 6, 2006
- Last updated
- Apr 29, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | E6241 | TX | Yes |
| 208600000X | Surgery | E7324 | AR |
Practice location
5002 Cowhorn Creek RdTexarkana, TX 75503-9766
Phone 903-614-3000 · Fax 903-614-3525
Mailing address
5002 Cowhorn Creek RdTexarkana, TX 75503-9766
Phone 903-614-3000 · Fax 903-614-3525
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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