KATHERINE R BLAKELEY MD PA
Osteopathic Medicine at Forest Ln, Dallas, TX

License number
Texas H7905
Category
Osteopathic Medicine
Type
Pediatric Anesthesiology
Owner
Name: DR. KATHERINE R BLAKELEY MD
Title: PRESIDENT
Phone: (972) 566-7777
Address
Address
7777 Forest Ln SUITE A-310, Dallas, TX 75230
National Provider ID: 1326103797
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KATHERINE R. BLAKELEY, M.D., PA

7777 Frst Ln STE B238, Dallas, TX 75230

Industry:
Medical Doctor's Office
Doing business as:
Katherine R. Blakeley, M.D., PA
Registration:
Apr 20, 1998
State ID:
0081900903
Business type:
Professional Association
President , Treasurer , Secretary , Director , Member , Vice-President:
Katherine R. Blakeley (President , Treasurer , Secretary , Director , Member , Vice-President)
Agent:
Katherine R Blakeley,7777 Frst Ln B-238, Dallas, TX 75230 (Physical)
TIN:
32036005380

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