Individual provider · Type 1 NPI

Rauvi Vidad Blackwell

Psychiatric/Mental Health Nurse Practitioner · Lewisville, TX

NPI number 1609319052 Active

Practice location

860 Hebron Pkwy, Suite 1101
Lewisville, TX 75057-5151

Call (469) 444-2244 Map

Fax (214) 488-1200

Mailing address

1208 Sundown Dr
Flower Mound, TX 75028-3998

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	AP132753 (TX)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1609319052

Rauvi Vidad Blackwell's National Provider Identifier is 1609319052, issued on Dec 2, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lewisville, TX. The record was last updated on Dec 6, 2016.