Healthcare Provider Details

I. General information

NPI: 1922695477
Provider Name (Legal Business Name): HILLARY DIANNE COLLINS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 12/30/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14761 HIGHWAY 150
COLDSPRING TX
77331
US

IV. Provider business mailing address

PO BOX 400
COLDSPRING TX
77331-0400
US

V. Phone/Fax

Practice location:
  • Phone: 936-653-8201
  • Fax: 936-653-8203
Mailing address:
  • Phone: 936-653-8201
  • Fax: 936-653-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48517
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: