National Provider Identifier Database

BLAYNE K STREET, DO – NPI #1568811636
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

BLAYNE K STREET, DO
301 JENNY GEORGE LANE
BUILDING B, SUITE 5
SWEETWATER, TX79556
Phone: 325-219-6175
Fax: 325-219-6179
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X
Family Medicine - Sports Medicine 207QS0010X

* Indicates primary specialty

NPI Profile & details for BLAYNE K STREET

NPI Number 1568811636
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/08/2016
Last updated 06/13/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • TX License #: S6314
  • TX Medicaid: 426407901
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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