| Dr Misty Hallonquist Blalock, NP | |
|
1304 Linda Dr, Daingerfield, TX 75638-2130 | |
| (430) 226-5110 | |
| (430) 226-5111 |
| Full Name | Dr Misty Hallonquist Blalock |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1304 Linda Dr, Daingerfield, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114928439 | NPI | - | NPPES |
| 12008144 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 651612 (Texas) | Primary |
| Entity Name | Odessa Physician Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457398364 PECOS PAC ID: 8426940115 Enrollment ID: O20040326001291 |
| Entity Name | Navarro Emergency Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851523252 PECOS PAC ID: 1254487861 Enrollment ID: O20090923000744 |
| Entity Name | Texarkana Emergency Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871813345 PECOS PAC ID: 4486778669 Enrollment ID: O20100824001147 |
| Entity Name | Total Point - Desoto Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104590330 PECOS PAC ID: 0749679702 Enrollment ID: O20211112000123 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Misty Hallonquist Blalock, NP 200 Corporate Blvd, Lafayette, LA 70508-3870 Ph: (800) 893-9698 | Dr Misty Hallonquist Blalock, NP 1304 Linda Dr, Daingerfield, TX 75638-2130 Ph: (430) 226-5110 |
Autumn Marie Barnard, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1402 Linda Dr, Daingerfield, TX 75638 Phone: 903-434-8066 Fax: 903-577-6562 |