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General NPI Number Information
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NPI Number | 1467339135
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Entity Type | Individual
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Provider Name | COLLIN BLACKWELL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2025
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Last Update Date | 08/24/2025
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Provider Practice Location Address
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Address Line | 4502 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4402
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Country | US
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Telephone | 210-743-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 5623 HAMILTON WOLFE APT 433
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City | SAN ANTONIO
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State | TX
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Zip | 78240-4054
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Country | US
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Telephone | 806-335-6224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 75775
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License Number State | TX
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