| NPI | 1285819516 |
|---|---|
| Other Name | J. BLAKE BOLIN, M.D. |
| Entity Type | Organization |
| Authorized Contact | DONNA K WARD Billing Rep 214-551-5101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K8014) |
| Enumeration Date | 2008-01-06 |
| Last Update Date | 2008-01-06 |