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General NPI Number Information
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NPI Number | 1649061706
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Entity Type | Organization
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Legal Business Name | BLOCKER PREVENTIVE MEDICINE PLLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 6100 HARRIS PKWY STE 250
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City | FORT WORTH
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State | TX
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Zip | 76132-4132
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Country | US
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Telephone | 817-433-1430
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1087
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City | GRANBURY
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State | TX
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Zip | 76048-8087
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Country | US
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Telephone | 682-200-9352
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Fax | 866-271-0102
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Authorized Official
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Title or Position | OWNER
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Name | DAVID E BLOCKER
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Credential | MD, MPH
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Telephone | 682-200-9352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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