Provider Demographics
NPI:1013263425
Name:HOLLINGSWORTH, ROBERT LEE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:HOLLINGSWORTH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 N TOWN EAST BLVD
Mailing Address - Street 2:T-2572
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4105
Mailing Address - Country:US
Mailing Address - Phone:214-302-2960
Mailing Address - Fax:214-302-2971
Practice Address - Street 1:1629 N TOWN EAST BLVD
Practice Address - Street 2:T-2572
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4105
Practice Address - Country:US
Practice Address - Phone:214-302-2960
Practice Address - Fax:214-302-2971
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52054183500000X
ARPD11980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist