DAVID M BLACKLOCK (NPI# 1801804570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801804570 |
| Entity Type | Individual |
| Full Name | DAVID M BLACKLOCK |
| Credential | DO |
| Practice Address |
100 Hillcrest Medical Blvd Waco TX 76712-8897 |
| Mailing Address |
Po Box 844658 Dallas TX 75284-4658 |
| Practice Telephone | 2542022000 |
| Practice Fax Number | 2542025849 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | F5119 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 123356105 | 05 | |
| TX | 125756005 | 05 | |
| TX | BCBS | 8AM187 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851503593 | David Michael Blacklock Jr. | Anesthesiology | 521 Parnassus Ave, Rm C-450, San Francisco, CA 94143-2206 | 2007-05-04 |
| Street Address |
100 HILLCREST MEDICAL BLVD |
| City | WACO |
| State | TX |
| Zip Code | 76712-8897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639177462 | Tamsak Kanoklukul | Nurse Anesthetist, Certified Registered | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2005-07-14 |
| 1851992184 | Heather Ann Johnson | Registered Nurse | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2020-11-03 |
| 1013542372 | Samuel Kelly | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2020-03-06 |
| 1902457047 | Megan R Fortenberry | Nurse Practitioner | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-09-20 |
| 1275188732 | Betty Jean Gonzalez | Nurse Practitioner | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-08-01 |
| 1073166559 | Ricardo G Altahif Jr. | Occupational Therapist | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-07-23 |
| 1184286148 | Julia Melee Jones | Physician Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-06-30 |
| 1194386870 | Daniel Roy Beane | Anesthesiologist Assistant | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-06-24 |
| 1376100875 | Meryl Lee Boutte | Anesthesiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-05-21 |
| 1982178018 | Kenneth James Roeger | Nurse Anesthetist, Certified Registered | 100 Hillcrest Medical Blvd, Waco, TX 76712 | 2019-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634294 | Waco Ophthalmology, Pllc | Ophthalmology | 602 W Highway 6, Waco, TX 76712 | 2020-03-19 |
| 1326692872 | Oceans Behavioral Hospital of Waco LLC | Psychiatric Hospital | 5931 Crosslake Parkway, Waco, TX 76712 | 2019-08-01 |
| 1831759620 | Jessica Ngoc Vien | Optometrist | 1000 Hwy 6, Ste 210, Waco, TX 76712 | 2019-06-14 |
| 1780150888 | Chelsea Cannon | Occupational Therapist | 330 W State Hwy 6, Waco, TX 76712 | 2018-10-17 |
| 1669955399 | Elizabeth Ann Barnhill | Speech-Language Pathologist | 15003 Riatta Rd, Woodway, TX 76712 | 2018-09-09 |
| 1447731617 | Melanie A Melton | Physical Therapist | 300 West Highway 6, Waco, TX 76712 | 2018-08-27 |
| 1396226403 | Gala Kaye Czajkoski | Occupational Therapy Assistant | 300 West Hightway 6, Waco, TX 76712 | 2018-08-27 |
| 1619457454 | Monica Anderson | Physical Therapy Assistant | 300 W Hwy 6, Waco, TX 76712 | 2018-08-21 |
| 1295238368 | Waco Sn Opco LLC | Skilled Nursing Facility | 7501 Bagby, Waco, TX 76712 | 2018-03-14 |
| 1558872952 | C. Guy Fps, Pllc | Otolaryngology | 1129 Aberdeen Rd, Waco, TX 76712 | 2017-10-12 |
| Find all providers in zip 76712 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104244201 | Kyle Sulak | Anesthesiology | 405 Londonderry Dr Ste 105, Waco, TX 76712 | 2014-04-04 |
| 1851735716 | Kathryn M Emadi | Anesthesiology | 405 Londonderry Dr Suite 104, Waco, TX 76712 | 2013-04-23 |
| 1811140981 | Philip George Cochran | Anesthesiology | 403 Riverview Dr, Waco, TX 76712-7607 | 2008-11-03 |
| 1831361328 | Laurie Wagnon Lazott | Anesthesiology | 50 Hillcrest Medical Blvd Ste 201b, Waco, TX 76712-8954 | 2008-03-25 |
| 1669493292 | Central Texas Anesthesiology Associates Inc | Anesthesiology | 3000 Herring, Waco, TX 76708 | 2006-07-21 |
| 1679561989 | Nelson D Destaffany Md Pa | Anesthesiology | 405 Londonderry Dr, Suite 105, Waco, TX 76712-7924 | 2005-10-11 |
| 1376100875 | Meryl Lee Boutte | Anesthesiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2019-05-21 |
| 1801243944 | Steven Carter Eubank | Anesthesiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2016-05-18 |
| 1265851232 | Adam Spjute | Anesthesiology | 7005 Woodway Dr Ste 101, Waco, TX 76712-6160 | 2014-04-07 |
| 1457784142 | Meagan Meyer | Anesthesiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2013-08-16 |
| Find all providers in WACO | ||||
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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.