Blaylock Anesthesia Group

NPI #1225347396 in Bridgeport, Texas

Provider Information

NPI Number: 1225347396
Entity Type: Organization
Organization Name: Blaylock Anesthesia Group
Primary Specialty: Contractor
Enumeration Date: Oct 6, 2010
Last Updated: Oct 6, 2010

Practice Location

Address: 1905 DOCTORS HOSPITAL DR
City: Bridgeport
State: Texas
ZIP Code: 76426-2260
Phone: (940) 683-0300

Authorized Official

Name: WINNIE C BLAYLOCK, CRNA
Title: SOLE PROPRIETOR
Phone: (940) 683-0300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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