Maria Magdalena Blalock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1044360 Issued in TX

Practice address

1105 W Frank Ave Ste 110
Lufkin, TX 75904-3302

Phone

(936) 634-1620

Fax

(936) 639-8972

NPI assigned

Jun 17, 2025

Last updated

Dec 22, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
• Direct secure messaging: maria.blalock.1@13578.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baylor St. Luke's Medical Group

  • Internal Medicine Physician
  • The Woodlands, TX
  • NPI 1740485879

  Family

  Medicare reassignment Care Compare group NPD
• Memorial Multispecialty Associates

  dba Baylor St. Luke's Medical Group - Urgent Care

  • Urgent Care Clinic/Center
  • The Woodlands, TX
  • NPI 1295789337

  Family

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1114813805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 OAK CIR",
            "city": "CORRIGAN",
            "state": "TX",
            "postal_code": "759393804",
            "telephone_number": "972-921-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W FRANK AVE STE 110",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043302",
            "telephone_number": "936-634-1620",
            "fax_number": "936-639-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "MARIA",
        "middle_name": "MAGDALENA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1044360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shonna Nicole Bizzell
• Lynn Sobray Blackwell, OTR
• Blaine Randall Blakestad MD PA
• Cindy Blake
• Blaine Randall Blakestad, MD
• Bonnie Lynn Bodenstedt, OTR/L
• Ivonne Boeta, MD
• Audrey Katherine Bogue, RD
• Donald B Bogue, OD
• Kaydi Joa Boles, SLP

• Family Nurse Practitioner in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.