Active NPI
Lisa Wolff Guajardo, RPH
- Pharmacist
- Kyle, TX
National Provider Identifier
1003416181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28187
- Practice address
- 5754 Kyle Pkwy
Kyle, TX 78640-2404 - Phone
- (512) 268-0412
- Fax
- (512) 268-1791
- NPI assigned
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28187 | TX | Primary |
Addresses
Primary practice location
5754 Kyle Pkwy
Kyle, TX 78640-2404
Mailing address
190 Applewood Dr
Driftwood, TX 78619-4503
Phone (281) 414-8952
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28187 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1003416181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 APPLEWOOD DR",
"city": "DRIFTWOOD",
"state": "TX",
"postal_code": "786194503",
"telephone_number": "281-414-8952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5754 KYLE PKWY",
"city": "KYLE",
"state": "TX",
"postal_code": "786402404",
"telephone_number": "512-268-0412",
"fax_number": "512-268-1791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUAJARDO",
"first_name": "LISA",
"middle_name": "WOLFF",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "28187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kyle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.