Individual
LEE JAY BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
12040 7TH ST, SANTA FE, TX 77510-8627
(409) 392-5719
Mailing address
12040 7TH ST, SANTA FE, TX 77510-8627
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
30206
TX
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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