Steven Lance Blackstone

NPI #1730415613 in Live Oak, Texas

Provider Information

NPI Number: 1730415613
Entity Type: Individual
Name: Steven Lance Blackstone
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Oct 27, 2009
Last Updated: Oct 17, 2011

Practice Location

Address: 12402 TOEPPERWEIN RD
City: Live Oak
State: Texas
ZIP Code: 78233-3230
Phone: (512) 351-0021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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