Healthcare Provider Details

I. General information

NPI: 1639088768
Provider Name (Legal Business Name): JULIA BLACKBURN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 HIGHWAY 16
COMANCHE TX
76442-4462
US

IV. Provider business mailing address

106 JUSTIN CT
STEPHENVILLE TX
76401-6142
US

V. Phone/Fax

Practice location:
  • Phone: 254-879-4980
  • Fax:
Mailing address:
  • Phone: 254-967-4991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number37977
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: