Provider Demographics
NPI:1285938654
Name:BLACKWELL, MONTE R (RESPIRATORY THERAPIS)
Entity type:Individual
Prefix:MR
First Name:MONTE
Middle Name:R
Last Name:BLACKWELL
Suffix:
Gender:M
Credentials:RESPIRATORY THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 DORA LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9759
Mailing Address - Country:US
Mailing Address - Phone:956-451-6655
Mailing Address - Fax:
Practice Address - Street 1:5007 DORA LN
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9759
Practice Address - Country:US
Practice Address - Phone:956-451-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67909227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified