Provider Demographics
NPI:1023028800
Name:HYBERBARIC MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HYBERBARIC MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-949-7233
Mailing Address - Street 1:13810 SUNTAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6053
Mailing Address - Country:US
Mailing Address - Phone:361-949-7233
Mailing Address - Fax:
Practice Address - Street 1:13810 SUNTAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6053
Practice Address - Country:US
Practice Address - Phone:361-949-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD0801207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0018KKOtherBCBS
TX0018KKOtherBCBS
TX=========OtherTAX ID
TX8C6777Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE