BLAYNE K STREET

SWEETWATER, TX
NPI1568811636
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: TX  S6314)
Additional Taxonomies207QS0010X Family Medicine, Sports Medicine
(Licence: TX  S6314)
Enumeration Date2016-06-08
Last Update Date2022-06-13
Business Address
Dr. BLAYNE K STREET D.O.
301 JENNY GEORGE LANE BUILDING B, SUITE 5
SWEETWATER, TX 79556
Phone number: 325-219-6175
Mailing Address
Dr. BLAYNE K STREET D.O.
301 JENNY GEORGE LN BUILDING B, SUITE 5
SWEETWATER, TX 79556-7152
Phone number: 325-219-6175