Provider Demographics
NPI:1336635788
Name:ROSCOE, CHELSEY ADRIANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:ADRIANNA
Last Name:ROSCOE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:ADRIANNA
Other - Last Name:STOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11604 FAUBIAN LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4981
Mailing Address - Country:US
Mailing Address - Phone:903-244-7323
Mailing Address - Fax:
Practice Address - Street 1:1901 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-423-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist