Provider Demographics
NPI:1215087713
Name:MORRISON, BLAKE ALAN (MD)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:ALAN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58538
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8538
Mailing Address - Country:US
Mailing Address - Phone:281-816-3091
Mailing Address - Fax:832-905-3942
Practice Address - Street 1:600 N KOBAYASHI STE 212
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-816-3091
Practice Address - Fax:832-905-3942
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND109842086S0105X
NDPT109842086S0105X
TXL70582086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1726390Medicaid
TX0037MQOtherBCBS GROUP (P.A.) NO.
TX8S2450OtherBLUE CROSS INDIVIDUAL NO.
TN00597XMedicare ID - Type UnspecifiedGROUP (P.A.)
NDN713796Medicare PIN
TX1726390Medicaid
TXI20809Medicare UPIN
TX0037MQOtherBCBS GROUP (P.A.) NO.
TX8S2450OtherBLUE CROSS INDIVIDUAL NO.