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Individual

DR. NICHOLAS WAYNE BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH. PHARM. D.

Contact information

Practice address
400 W 2ND ST, HEARNE, TX 77859-2566
(979) 492-2404
(979) 279-3374
Mailing address
400 W 2ND ST, HEARNE, TX 77859-2566
(979) 492-2404

Taxonomy

Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
58974
TX

Other

Enumeration date
09/16/2020
Last updated
09/16/2020
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