Mountain West Derm - Blackhart Pllc
NPI #1366018848 in Georgetown, Texas
Provider Information
- NPI Number
- 1366018848
- Entity Type
- Organization
- Organization Name
- Mountain West Derm - Blackhart Pllc
- Primary Specialty
- Dermatology
- Enumeration Date
- Jun 3, 2021
- Last Updated
- Jun 14, 2021
Practice Location
- Address
- 4513 WILLIAMS DR
- City
- Georgetown
- State
- Texas
- ZIP Code
- 78633-1302
- Phone
- (512) 930-3909
Authorized Official
- Name
- BRET S BLACKHART, MD
- Title
- PRESIDENT
- Phone
- (775) 336-3624
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery |
| Dermatology - Dermatopathology — Dermatopathology |
| Dermatology |
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