Provider Demographics
NPI:1376150607
Name:BLANCO, ONDRIA ELISABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ONDRIA
Middle Name:ELISABETH
Last Name:BLANCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 HANOVER DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-6357
Mailing Address - Country:US
Mailing Address - Phone:626-274-2914
Mailing Address - Fax:
Practice Address - Street 1:3650 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2934
Practice Address - Country:US
Practice Address - Phone:469-347-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist