CHARLIE S. BLALOCK

FORT WORTH, TX
NPI1861530156
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  668515)
Enumeration Date2007-02-01
Last Update Date2009-02-05
Business Address
Mr. CHARLIE S. BLALOCK CRNA
4916 OVERTON PLZ
FORT WORTH, TX 76109-4415
Phone number: 800-480-1819
Mailing Address
Mr. CHARLIE S. BLALOCK CRNA
PO BOX 50667
AMARILLO, TX 79159-0667
Phone number: 800-480-1819