Provider Demographics
NPI:1467049940
Name:ALBRECHT, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:ALBRECHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-0273
Mailing Address - Country:US
Mailing Address - Phone:254-675-8398
Mailing Address - Fax:
Practice Address - Street 1:506 WEST 5TH STREET
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634
Practice Address - Country:US
Practice Address - Phone:254-675-8398
Practice Address - Fax:254-675-4355
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist