BLAINE RANDALL BLAKESTAD MD PA (NPI# 1124346598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124346598 |
| Entity Type | Organization |
| Organization Name | BLAINE RANDALL BLAKESTAD MD PA |
| Practice Address |
1201 W Frank Ave Lufkin TX 75904-3357 |
| Mailing Address |
702 Brentwood Dr Lufkin TX 75901-8853 |
| Practice Telephone | 9366348111 |
| Mailing Telephone | 9366325894 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-09-09 |
| Authorized Official Name | DR. BLAINE RANDALL BLAKESTAD (PRESIDENT) |
| Authorized Official Telephone | 9366325894 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
F1391 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1201 W FRANK AVE |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629059548 | Joe Parker Tait | Registered Nurse | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2005-11-08 |
| 1851955033 | Shaquitta Lashae Hood | Licensed Vocational Nurse | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2019-04-23 |
| 1730653841 | Alejos Salais Jr. | Nurse Anesthetist, Certified Registered | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2019-01-11 |
| 1881173060 | Hospitalist Medicine Physicians of Texas - Lufkin, Pllc | Internal Medicine | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2018-08-09 |
| 1528578051 | Destiny Michelle New | Nurse Practitioner | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2017-10-11 |
| 1144748286 | Pineywoods Pain Associates, Pllc | Nurse Anesthetist, Certified Registered | 1201 W Frank Ave, Anesthesia Department, Lufkin, TX 75904-3357 | 2017-09-08 |
| 1336675032 | Patrick Imonitie Igharosa | Internal Medicine | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2017-05-02 |
| 1972053684 | Patricia Gay Lawson | Nurse Practitioner | 1201 W Frank Ave, Lufkin, TX 75904 | 2016-10-05 |
| 1811445091 | Morgan Grebe | Physician Assistant | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2016-09-15 |
| 1083162473 | Memorial Health System of East Texas | Clinic/Center | 1201 W Frank Ave, Lufkin, TX 75904 | 2016-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 2083P0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Undersea and Hyperbaric Medicine |
| A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881641975 | Blaine Randall Blakestad | Preventive Medicine | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447321 | Central Texas Wound Healing Associates, Pllc | Preventive Medicine | 2300 Clear Creek Rd Ste 101, Killeen, TX 76549-4985 | 2020-11-05 |
| 1003470618 | Healogy Group Pllc | Preventive Medicine | 401 W Campbell Rd Ste 300, Richardson, TX 75080-3416 | 2019-04-29 |
| 1114498672 | Alpha Hyperbarics Pllc | Preventive Medicine | 1845 Precinct Line Road, Ste 105, Hurst, TX 76054 | 2018-12-10 |
| 1134694532 | Natividad Wound Care, LLC | Preventive Medicine | 138 Zamora Medical Cir, Eagle Pass, TX 78852-5924 | 2018-10-11 |
| 1659887248 | Rrr Hyperbarics 5, LLC | Preventive Medicine | 4150 N. Collins Street, Arlington, TX 76005 | 2017-12-19 |
| 1588179055 | Jaimi Lynne Stockstill | Preventive Medicine | 6161 N State Highway 161 Ste 310, Irving, TX 75038-2220 | 2017-12-06 |
| 1922511898 | Wound Care & Research Center of North Texas Pllc | Preventive Medicine | 502 N Valley Pkwy Ste 1, Lewisville, TX 75067-3437 | 2017-11-14 |
| 1093225518 | Dfw Wound & Hyperbarics, P.a. | Preventive Medicine | 2301 Marsh Ln Ste 200, Plano, TX 75093-8497 | 2017-10-10 |
| 1851800361 | Physicians Wound Care Pllc | Preventive Medicine | 4499 Medical Dr Ste Sl2, San Antonio, TX 78229-3722 | 2017-09-27 |
| 1205367455 | Rrr Hyperbarics 4 | Preventive Medicine | 1720 Fm 544, Lewisville, TX 75056-4592 | 2017-03-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.