Provider Demographics
NPI:1962458075
Name:BLOCK, STEVEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:BLOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93128
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79493-3128
Mailing Address - Country:US
Mailing Address - Phone:806-788-4368
Mailing Address - Fax:806-788-4369
Practice Address - Street 1:5115 80TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3017
Practice Address - Country:US
Practice Address - Phone:806-788-4369
Practice Address - Fax:806-788-4369
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3163207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118747803Medicaid
TX85E322Medicare ID - Type Unspecified