MEDICARE: MR. ROBERT A SOWDER R.PH.

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
1	183500000X	Pharmacist	34546	TX

General Provider Information

NPI Number	:	1487656419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT A SOWDER R.PH.

Provider Business Mailing Address
First Line	:	4208 GORMAN AVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-5137
Country	:	US
Telephone Number	:	254-753-2959
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 MEMORIAL DR
Second Line	:	PHARMACY SERVICE (119)
City	:	WACO
State	:	TX
Zip	:	76711-1329
Country	:	US
Telephone Number	:	254-297-3841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/12/2016

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Directions to “ MR. ROBERT A SOWDER R.PH.” Practice Location

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