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NPI Code Detail

MEDICARE: DAMOND BLUEITT M.D.

MEDICARE: DAMOND BLUEITT 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
1207QS0010XSports Medicine (Family Medicine) PhysicianN2407TX

General Provider Information

NPI Number : 1790949352
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMOND BLUEITT M.D.
Provider Business Mailing Address
First Line : 8210 WALNUT HILL LN STE 130
Second Line :
City : DALLAS
State : TX
Zip : 75231-4418
Country : US
Telephone Number : 214-750-1207
Fax Number : 217-750-8504
Provider Business Practice Location Address
First Line : 5900 ALTAMESA BLVD STE 100
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-5473
Country : US
Telephone Number : 817-854-9969
Fax Number : 817-854-9965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2008
Last Update Date : 03/18/2026

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