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1871023051
DOUGLAS LEE BLAKE
ARLINGTON, TX
NPI
1871023051
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX PA05784)
Enumeration Date
2017-06-19
Last Update Date
2017-06-19
Business Address
Mr. DOUGLAS LEE BLAKE PA-C
210 W SOUTH ST
ARLINGTON, TX 76010-7134
Phone number: 817-277-9597
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Mailing Address
Mr. DOUGLAS LEE BLAKE PA-C
PO BOX 2031
FORT WORTH, TX 76113-2031
Phone number: 817-845-3587
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