Provider Demographics
NPI:1770210957
Name:CARRASCO, ABIGAIL CORINNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:CORINNE
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NICCI LN
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-1549
Mailing Address - Country:US
Mailing Address - Phone:806-382-6599
Mailing Address - Fax:
Practice Address - Street 1:5601 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4141
Practice Address - Country:US
Practice Address - Phone:806-352-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist