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NPI Code Detail

MEDICARE: DR. SEAN M REVELL PHARMD

MEDICARE: DR. SEAN M REVELL 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
1183500000XPharmacist47522TX

General Provider Information

NPI Number : 1477881498
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN M REVELL PHARMD
Provider Business Mailing Address
First Line : 3601 ANDREWS HWY APT 803
Second Line :
City : MIDLAND
State : TX
Zip : 79703-4956
Country : US
Telephone Number : 806-206-7270
Fax Number :
Provider Business Practice Location Address
First Line : 1305 W UNIVERSITY BLVD
Second Line :
City : ODESSA
State : TX
Zip : 79764-7121
Country : US
Telephone Number : 432-580-0166
Fax Number : 432-337-1326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2009
Last Update Date : 12/02/2009

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Directions to “ DR. SEAN M REVELL PHARMD” Practice Location

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