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General NPI Number Information
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NPI Number | 1144304718
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Entity Type | Organization
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Legal Business Name | MARY ANN BLOCK DO PA
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1750 NORWOOD DRIVE
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City | HURST
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State | TX
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Zip | 76054
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Country | US
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Telephone | 817-280-9933
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Fax | 817-280-9966
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Provider Business Mailing Address
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Address Line | 1750 NORWOOD DRIVE
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City | HURST
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State | TX
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Zip | 76054
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Country | US
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Telephone | 817-280-9933
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Fax | 817-280-9966
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY ANN BLOCK
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Credential |
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Telephone | 817-280-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | H7906
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License Number State | TX
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