MEDICARE: DR. AMIE TAGGART BLASZCZYK PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	43541	TX
2	1835P1200X	Pharmacotherapy Pharmacist	43541	TX
3	1835P1300X	Psychiatric Pharmacist	43541	TX

General Provider Information

NPI Number	:	1548241649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIE TAGGART BLASZCZYK PHARM.D.

Provider Business Mailing Address
First Line	:	9201 GARLAND RD
Second Line	:	APT 121
City	:	DALLAS
State	:	TX
Zip	:	75218-3620
Country	:	US
Telephone Number	:	214-321-1782
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:	BUILDING 7-R# 119A
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-372-5300
Fax Number	:	214-372-5020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	09/11/2025

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