Carl J Blackburn OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1771TG Issued in TX

Legal business name

CARL J BLACKBURN OD LLC

Practice address

5655 E Sam Houston Pkwy N
Houston, TX 77015-3250

Phone

(713) 450-4484

Fax

(713) 450-4424

NPI assigned

Aug 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Carl Joseph Blackburn, O.D.

Title

Owner / Sole Member

Phone

(281) 852-4440

Specialties & licenses 1

Addresses

Other names 1

• Family Eye Clinic of Houston, LLC Doing business as

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1124375498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 DOLPHIN ARC DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773468199",
            "telephone_number": "281-852-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 E SAM HOUSTON PKWY N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153250",
            "telephone_number": "713-450-4484",
            "fax_number": "713-450-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL J BLACKBURN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER / SOLE MEMBER",
        "authorized_official_telephone_number": "281-852-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1771TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Clinic of Houston, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caring Professional Home Health Services, I
• Marisa Renee Carino Mason, MD
• Caritas Health Care, LLC
• Carl B, Rountree, M.D. & Associates
• Carl D. Bloom, D.M.D., P.a.
• Carl Rountree, M.D. & Associates
• Carl V. Mitten, D.O. P.a.
• Carl V. Mitten, D.O., P.a.
• Adrienne Carl, RN
• Frank B. Carle, M.A., BCBA

• Optometrist in Houston, TX
• Providers in Houston, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.