Provider Demographics
NPI:1821312513
Name:GURROLA, SANDRA ROYO (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ROYO
Last Name:GURROLA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21106 NATCHEZ CROSSING ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4747
Mailing Address - Country:US
Mailing Address - Phone:713-728-1202
Mailing Address - Fax:
Practice Address - Street 1:6675 W BELLFORT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-2058
Practice Address - Country:US
Practice Address - Phone:713-728-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist