MEDICARE: BLAHA FAMILY MEDICAL CLINIC

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	363LF0000X	Family Nurse Practitioner	645587	TX
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1538574603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLAHA FAMILY MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	3626 N HALL ST
Second Line	:	STE 600
City	:	DALLAS
State	:	TX
Zip	:	75219-5105
Country	:	US
Telephone Number	:	214-219-3260
Fax Number	:	214-219-3329

Provider Business Practice Location Address
First Line	:	3626 N HALL ST
Second Line	:	STE 600
City	:	DALLAS
State	:	TX
Zip	:	75219-5105
Country	:	US
Telephone Number	:	214-219-3260
Fax Number	:	214-219-3329

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD BLAHA
Credential	:	N.P., D.C.
Telephone Number	:	214-219-3260

Provider Enumeration Date	:	06/26/2014
Last Update Date	:	06/26/2014

Similar Medicare Providers

1053515528 — DEENA S. HARBAUGH M.S., LPC
Practice Location Address:

3626 N HALL ST , SUITE619
DALLAS, TX
75219-5105

Practice Phone: 469-324-7909
Practice Fax: 214-275-6900

1235315904 — BRAUN MEDICAL ASSOCIATION, PA
Practice Location Address:

3626 N HALL ST , SUITE 900
DALLAS, TX
75219-5105

Practice Phone: 214-698-1081
Practice Fax:

1447607585 — CHRISTOPHER DUFOUR
Practice Location Address:

3626 N HALL ST # 550
DALLAS, TX
75219-5105

Practice Phone: 214-305-2110
Practice Fax:

1952822553 — DR. KATIE LYNN SHARP PHD
Practice Location Address:

3626 N HALL ST
DALLAS, TX
75219-5105

Practice Phone: 214-305-2110
Practice Fax:

1326562901 — MR. BLAKE RANDOLPH NUNNELEY LPC
Practice Location Address:

3626 N HALL ST STE 530
DALLAS, TX
75219-5105

Practice Phone: 214-606-2484
Practice Fax: 214-942-3304

1396231064 — CRYSTAL GAYLE PHD
Practice Location Address:

3626 N HALL ST STE 550
DALLAS, TX
75219-5105

Practice Phone: 214-305-2110
Practice Fax:

Directions to “BLAHA FAMILY MEDICAL CLINIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.