Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 8124 | TX |
NPI | 1821159351 |
---|---|
Provider Name | Dr. Christopher Ronald Blair |
First Address | Waco, TX 76710-5837 |
Second Address | Waco, TX 76710-5837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |