Sam N Blackstone Jr., RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

18204 Issued in TX

Practice address

718 W Lampasas St
Ennis, TX 75119-4534

Phone

(972) 875-6521

Fax

(972) 875-2677

NPI assigned

May 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922216241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 GLENEAGLES DR",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751197204",
            "telephone_number": "972-875-6521",
            "fax_number": "972-875-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 W LAMPASAS ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194534",
            "telephone_number": "972-875-6521",
            "fax_number": "972-875-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTONE",
        "first_name": "SAM",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "18204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Lourdes Bautista
• Baylor Surgicare at Ennis LLC
• Sherri Lynn Berry, COTA
• Big Hearts MD Distributor, LLC
• Bio-Medical Applications of Texas, Inc. (Fresenius Medical Care Ennis)
• Blair Family Medicine PA
• Raymond Wesley Blair Jr., MD
• Kelechi Blanton, NP
• Bluebonnet Medical Care PA (Ennis Quick Care)
• Kimberly Jo Boxley

• Pharmacist in Ennis, TX
• Providers in Ennis, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.