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NPI Code Detail

MEDICARE: DR. ABIGAIL HOLLIS BLACKBURN DC

MEDICARE: DR. ABIGAIL HOLLIS BLACKBURN DC
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
1111N00000XChiropractor10841TX

General Provider Information

NPI Number : 1457521007
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABIGAIL HOLLIS BLACKBURN DC
Provider Business Mailing Address
First Line : 4107 MEDICAL PKWY
Second Line :
City : AUSTIN
State : TX
Zip : 78756-3735
Country : US
Telephone Number : 512-810-0667
Fax Number :
Provider Business Practice Location Address
First Line : 4107 MEDICAL PKWY STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78756-3736
Country : US
Telephone Number : 512-420-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2008
Last Update Date : 12/15/2016

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