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NPI Code Detail

MEDICARE: DR. SARAH GERVAIS ROSS PHARMD

MEDICARE: DR. SARAH GERVAIS ROSS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist60740TX

General Provider Information

NPI Number : 1225657059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH GERVAIS ROSS PHARMD
Provider Business Mailing Address
First Line : 115 CALM WATER LOOP
Second Line :
City : BASTROP
State : TX
Zip : 78602-2168
Country : US
Telephone Number : 979-203-1613
Fax Number :
Provider Business Practice Location Address
First Line : 2508 S DAY ST
Second Line :
City : BRENHAM
State : TX
Zip : 77833-5521
Country : US
Telephone Number : 979-277-0906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2020
Last Update Date : 04/12/2020

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