Provider Demographics
NPI:1134563067
Name:BLANKENBURG, ROBIN ELIZABETH (RPH)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:BLANKENBURG
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 1:4001 HIGHWAY 36 S
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-9610
Mailing Address - Country:US
Mailing Address - Phone:979-277-1349
Mailing Address - Fax:979-277-1350
Practice Address - Street 1:4001 HIGHWAY 36 S
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-9610
Practice Address - Country:US
Practice Address - Phone:979-277-1349
Practice Address - Fax:979-277-1350
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist