Provider Demographics
NPI:1104949841
Name:BLAIR, MICHAEL ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:BLAIR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:801 W RANDOL MILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2505
Mailing Address - Country:US
Mailing Address - Phone:817-277-6433
Mailing Address - Fax:
Practice Address - Street 1:801 W RANDOL MILL RD STE 201
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2505
Practice Address - Country:US
Practice Address - Phone:817-277-6433
Practice Address - Fax:817-277-9086
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2020-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE24539207W00000X
TXP5158207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology