NPIMap

Individual provider Active NPI

Alvin Carl Selleck, RPH.

  • Pharmacist
  • Spring, TX
National Provider Identifier
1386973683
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28409 Issued in TX
Practice address
19302 Kuykendahl Rd
Spring, TX 77379-3404
Phone
(281) 353-8621
Fax
(281) 353-8602
NPI assigned
Dec 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28409 TX Primary

Addresses

Primary practice location

19302 Kuykendahl Rd
Spring, TX 77379-3404

Mailing address

19302 Kuykendahl Rd
Spring, TX 77379-3404
Phone (281) 353-8621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28409TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1386973683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19302 KUYKENDAHL RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793404",
            "telephone_number": "281-353-8621",
            "fax_number": "281-353-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19302 KUYKENDAHL RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793404",
            "telephone_number": "281-353-8621",
            "fax_number": "281-353-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLECK",
        "first_name": "ALVIN",
        "middle_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "28409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.