Provider Demographics
NPI:1790264646
Name:COLLINS, KIMBERLYN ANN (RPH BSPHARM)
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RPH BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 S POST OAK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4339
Mailing Address - Country:US
Mailing Address - Phone:713-551-9154
Mailing Address - Fax:
Practice Address - Street 1:9555 S POST OAK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4339
Practice Address - Country:US
Practice Address - Phone:713-551-9161
Practice Address - Fax:713-551-9162
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist