Provider Demographics
NPI:1942593777
Name:SELLARS, GINGER A (DPM)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:A
Last Name:SELLARS
Suffix:
Gender:F
Credentials:DPM
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Other - First Name:
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Mailing Address - Street 1:690 S LOOP 336 WEST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3319
Mailing Address - Country:US
Mailing Address - Phone:936-760-1200
Mailing Address - Fax:936-760-1210
Practice Address - Street 1:690 S LOOP 336 WEST
Practice Address - Street 2:SUITE 150
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3319
Practice Address - Country:US
Practice Address - Phone:936-760-1200
Practice Address - Fax:936-760-1210
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1974213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J21AOtherGROUP MEDICARE NUMBER
TX094010801OtherGROUP MEDICAID NUMBER