MEDICARE: DR. BLAIR CUSHING DO

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	207Q00000X	Family Medicine Physician	DO2023-1016	NM
2	207Q00000X	Family Medicine Physician	R9740	TX
3	207Q00000X	Family Medicine Physician	20A15275	CA
4	207Q00000X	Family Medicine Physician	036.161757	IL
5	207Q00000X	Family Medicine Physician	2022-03356	NC

General Provider Information

NPI Number	:	1982083713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLAIR CUSHING DO

Provider Business Mailing Address
First Line	:	PO BOX 1548
Second Line	:
City	:	SEASIDE
State	:	CA
Zip	:	93955-1548
Country	:	US
Telephone Number	:
Fax Number	:	956-306-6170

Provider Business Practice Location Address
First Line	:	214 N 16TH ST STE 204
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-7982
Country	:	US
Telephone Number	:	956-833-1466
Fax Number	:	956-306-6170

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	02/02/2026

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