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
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 SurgeryMOHS-Micrographic Surgery
Dermatology - DermatopathologyDermatopathology
Dermatology

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