Provider Demographics
NPI:1972821742
Name:ROACH, SHERRIE (RPH)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:
Last Name:ROACH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SHERRIE
Other - Middle Name:TUMA
Other - Last Name:BAUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2803 GRAND OAKS LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-904-0025
Mailing Address - Fax:
Practice Address - Street 1:12860 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3222
Practice Address - Country:US
Practice Address - Phone:512-506-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist