Black, Douglas Scott

Black, Douglas Scott is an individual health care provider with primary practice located at 1002 Texas Blvd Suite 401, Texarkana TX 75501-5107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Black, Douglas Scott can be contacted via phone (903) 794-8820.

Contact Information

Primary practice address
1002 Texas Blvd Suite 401 Texarkana TX 75501-5107
Phone: (903) 794-8820
Fax: (903) 794-8878
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X L0033 Texas

Profile Details

NPI number 1033108196
LBN Legal business name Black, Douglas Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Nov 4th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033108196 NPPES
Oklahoma MEDICAID 100848130B
Oklahoma MEDICAID 042154704
Oklahoma MEDICAID 140606001

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