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General NPI Number Information
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NPI Number | 1801680582
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Entity Type | Organization
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Legal Business Name | BLALOCK INNOVATIONS LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 3880 PARKWOOD BLVD STE 501
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City | FRISCO
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State | TX
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Zip | 75034-1931
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Country | US
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Telephone | 214-618-5719
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Fax |
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Provider Business Mailing Address
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Address Line | 3880 PARKWOOD BLVD STE 501
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City | FRISCO
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State | TX
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Zip | 75034-1931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN BLALOCK
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Credential | MD
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Telephone | 214-618-5719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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