Provider Demographics
NPI:1811022841
Name:ROBERTS, DON ALLEN (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:ALLEN
Last Name:ROBERTS
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 1:4926 MARINER TER
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-9492
Mailing Address - Country:US
Mailing Address - Phone:325-227-6886
Mailing Address - Fax:
Practice Address - Street 1:1926 N BRYANT BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-3744
Practice Address - Country:US
Practice Address - Phone:325-653-3271
Practice Address - Fax:325-653-3272
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist