MEDICARE: DR. HAROLD MORRIS BLOCK JR. M.D.

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	208D00000X	General Practice Physician	D0802	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104829084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD MORRIS BLOCK JR. M.D.

Provider Business Mailing Address
First Line	:	2126 MONTANA AVE.
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903
Country	:	US
Telephone Number	:	915-838-8484
Fax Number	:	915-351-2203

Provider Business Practice Location Address
First Line	:	2126 MONTANA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903
Country	:	US
Telephone Number	:	915-838-8484
Fax Number	:	915-351-2203

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	02/13/2009

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