Provider Demographics
NPI:1033749114
Name:BLASINGAME, ROBIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:BLASINGAME
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 RAMADA TRL
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79108-1230
Mailing Address - Country:US
Mailing Address - Phone:806-626-6504
Mailing Address - Fax:
Practice Address - Street 1:5730 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4004
Practice Address - Country:US
Practice Address - Phone:806-354-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty