Provider Demographics
NPI:1407356579
Name:GREGORY, ROY TAYLOR (PHARM D)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:TAYLOR
Last Name:GREGORY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-4805
Mailing Address - Country:US
Mailing Address - Phone:806-894-7315
Mailing Address - Fax:
Practice Address - Street 1:511 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-4805
Practice Address - Country:US
Practice Address - Phone:806-894-7315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist