Individual
BRUCE WILSON ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
4404 N LAURENT ST, VICTORIA, TX 77901-2742
(361) 576-6599
(361) 894-6431
Mailing address
4404 N LAURENT ST, VICTORIA, TX 77901-2742
(361) 576-6599
(361) 894-6431
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
21067
TX
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21067
STATE BOARD OF PHARMACY
TX
Enumeration date
02/08/2007
Last updated
10/30/2023
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