MEDICARE: RONALD J BLAHA D.C., RMT, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT024335	TX
2	363LF0000X	Family Nurse Practitioner	645587	TX
3	111N00000X	Chiropractor	8792	TX

General Provider Information

NPI Number	:	1659399749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD J BLAHA D.C., RMT, RN

Provider Business Mailing Address
First Line	:	8150 BROOKRIVER DR STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4068
Country	:	US
Telephone Number	:	214-219-3260
Fax Number	:	214-219-3329

Provider Business Practice Location Address
First Line	:	8150 BROOKRIVER DR STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4068
Country	:	US
Telephone Number	:	214-219-3260
Fax Number	:	214-219-3329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	03/20/2026

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