Provider Demographics
NPI:1700392545
Name:SELLERS, RICHARD MILTON (CRNA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MILTON
Last Name:SELLERS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HOSPITAL CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4772
Mailing Address - Country:US
Mailing Address - Phone:979-245-7246
Mailing Address - Fax:
Practice Address - Street 1:600 HOSPITAL CIR STE 200
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4772
Practice Address - Country:US
Practice Address - Phone:979-245-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX836743163W00000X
TXAP136407367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse