Jerry Blacklock
Neurosurgeon
6560 Fannin St Suite 900
Houston
, Texas 77030-2761
Jerry Blacklock
Neurosurgeon
6560 Fannin St Suite 900
Houston
, Texas 77030-2761
(713) 441-3800
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Jerry Blacklock
- 6560 Fannin St Suite 900
- Houston, TX
- Zip : 77030-2761
- Phone : (713) 441-3800
Second Address
- Jerry Blacklock
- 6560 Fannin St Suite 900
- Houston, TX
- Zip : 77030-2761
- Phone : (713) 441-3800
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | G9066 | TX |
National Provider Identifier
| NPI | 1124053392 |
|---|---|
| Provider Name | Jerry Blacklock |
| First Address | Houston, TX 77030-2761 |
| Second Address | Houston, TX 77030-2761 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/07/2006 |
| Last Update Date | 24/01/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 8EA863 | BLUE CROSS BLUE SHIELD (01) | TX |
| 8GD848 | BCBS (01) | TX |
| 8R9781 | BLUE CROSS BLUE SHIELD (01) | TX |
| P00216844 | RAILROAD MEDICARE (01) | TX |
| P01331480 | RR MEDICARE (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.