| David Blackburn, | |
|
306 Hospital Dr, Corsicana, TX 75110 | |
| (713) 515-7795 | |
| Not Available |
| Full Name | David Blackburn |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 306 Hospital Dr, Corsicana, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245233360 | NPI | - | NPPES |
| 038123801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0203X | Radiology - Therapeutic Radiology | F8411 (Texas) | Secondary |
| 2085R0001X | Radiology - Radiation Oncology | F8411 (Texas) | Primary |
| Entity Name | Corsicana Cancer Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275971533 PECOS PAC ID: 2365686334 Enrollment ID: O20131022001142 |
| Mailing Address | Practice Location Address |
|---|---|
| David Blackburn, 6524 Wakeforest Ave, Houston, TX 77005-3954 Ph: () - | David Blackburn, 306 Hospital Dr, Corsicana, TX 75110 Ph: (713) 515-7795 |
Dr. Homero Javier Chapa, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3422 Fm 2859, Corsicana, TX 75109 Phone: 903-872-2873 | |
Dr. Donald S. Willig, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 3201 W Highway 22, Corsicana, TX 75110 Phone: 817-321-0404 Fax: 817-321-0486 | |
Leslie A Kennedy, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3201 W Highway 22, Corsicana, TX 75110 Phone: 903-654-6822 Fax: 903-872-1132 |