| Doctor Name: | PROF. ROGER DARE BLOCKER |
| NPI Number: | 1023494390 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MIHL |
| License Number: | |
| Business Practice Address: | 2701 Alpine Trl San Marcos, TX - 786662422 |
| Business Phone Number: | 3256561482 |
| Business Fax Number: | |
| Mailing Address: | 2701 Alpine Trl, SAN MARCOS |
| State: | TX |
| Postal Code: | 786662422 |
| Phone Number: | 3256561482 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2015 |
| NPI Last Update Date: | 08/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |