Provider Demographics
NPI:1407452535
Name:SELLERS, ROBERT BRYAN (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRYAN
Last Name:SELLERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 W ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76501-4215
Mailing Address - Country:US
Mailing Address - Phone:254-774-1050
Mailing Address - Fax:254-774-1055
Practice Address - Street 1:514 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-4215
Practice Address - Country:US
Practice Address - Phone:254-774-1050
Practice Address - Fax:254-774-1055
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX290971835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care