Individual provider · NPI-1

David Dillard Blackerby II, CNC

Technician, Attendant Care Provider · San Antonio, TX

NPI number1730918848

StatusActive

Last updated in NPPESJan 10, 2025

Details

NPI: 1730918848
Entity type: Individual (NPI-1)
Name: Mr. David Dillard Blackerby II
Credential: CNC
Sex: Male
Sole proprietor: No
Enumeration date: Jul 29, 2024
Certification date: Jan 10, 2025
Last updated: Jan 10, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3747A0650X	Technician, Attendant Care Provider	–	–	Yes
146N00000X	Emergency Medical Technician, Basic	–	–
171W00000X	Contractor	–	TX
172A00000X	Driver	22130577	TX
3747P1801X	Technician, Personal Care Attendant	–	–
374U00000X	Home Health Aide	–	–

Practice location

3501 Pin Oak Dr Apt 1506
San Antonio, TX 78229-3032

Phone 210-238-4873

Mailing address

3501 Pin Oak Dr Apt 1506
San Antonio, TX 78229-3032

Phone 210-238-4873

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