Thousand Oaks Clinic Work Med

Primary specialty

SpecialistTaxonomy code 174400000X

License

MDC7546 Issued in TX

Legal business name

THOUSAND OAKS CLINIC WORK MED

Practice address

2235 Thousand Oaks Dr
Suite 115-117
San Antonio, TX 78232-3966

Phone

(210) 490-1000

Fax

(210) 490-3806

NPI assigned

Jul 12, 2005

Last updated

Aug 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Dennis Blackburn, MD

Title

Owner

Phone

(210) 490-1000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1669470811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 THOUSAND OAKS DR",
            "address_2": "SUITE 115-117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323966",
            "telephone_number": "210-490-1000",
            "fax_number": "210-490-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 THOUSAND OAKS DR",
            "address_2": "SUITE 115-117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323966",
            "telephone_number": "210-490-1000",
            "fax_number": "210-490-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOUSAND OAKS CLINIC WORK MED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-490-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "MDC7546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.