Provider Demographics
NPI:1700148558
Name:COLLINS, ANTHONY J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:J
Other - Last Name:AMENDOLIA
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 DRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7168
Mailing Address - Country:US
Mailing Address - Phone:267-254-4817
Mailing Address - Fax:254-791-2266
Practice Address - Street 1:1905 SW H K DODGEN LOOP
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-1814
Practice Address - Country:US
Practice Address - Phone:254-778-1731
Practice Address - Fax:254-791-2266
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4394791835G0303X
PARPI000841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPST.022028OtherLOUISIANA RPH LICENSE
MST-15093OtherMISSISSIPPI RPH LICENSE
OK17383OtherOKLAHOMA RPH LICENSE
TX55715OtherTEXAS RPH LICENSE
OK17383OtherOKLAHOMA RPH LICENSE
MST-15093OtherMISSISSIPPI RPH LICENSE
MD25350OtherMARYLAND RPH LICENSE
LAPST.022028OtherLOUISIANA RPH LICENSE