Provider Demographics
NPI:1255610879
Name:HOLGUIN, KEITH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:HOLGUIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 LITTLEROCK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-8102
Mailing Address - Country:US
Mailing Address - Phone:806-283-5359
Mailing Address - Fax:
Practice Address - Street 1:1401 N TURNER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4314
Practice Address - Country:US
Practice Address - Phone:575-393-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist