Individual
DR. CHARLES D BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
6204 BALCONES DR, AUSTIN, TX 78731-4214
(512) 427-9448
(512) 302-3928
Mailing address
10225 MATOCA WAY, AUSTIN, TX 78726-1379
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
38519
TX
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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