Provider Demographics
NPI:1447588652
Name:DROBLYN, JOHNATHON ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHNATHON
Middle Name:ANDREW
Last Name:DROBLYN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:A
Other - Last Name:DROBLYN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:224 HERITAGE CT
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-6704
Mailing Address - Country:US
Mailing Address - Phone:903-376-1881
Mailing Address - Fax:888-374-1180
Practice Address - Street 1:1404 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-6267
Practice Address - Country:US
Practice Address - Phone:903-881-5752
Practice Address - Fax:888-374-1180
Is Sole Proprietor?:No
Enumeration Date:2009-11-28
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX47475OtherTEXAS STATE BOARD OF PHARMACY