Samson Goitom Tesfaselassie

Primary specialty

PharmacistTaxonomy code 183500000X

License

62052 Issued in TX

Practice address

451 FM 548
Forney, TX 75126-6288

Phone

(972) 552-1633

NPI assigned

Jun 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Forney, TX
  • NPI 1427240746
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1013647338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 EMPIRE DR APT 5127",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750800111",
            "telephone_number": "773-319-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 FM 548",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751266288",
            "telephone_number": "972-552-1633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5950 Broadway Blvd",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750435822",
            "country_code": "US",
            "telephone_number": "972-303-3191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TESFASELASSIE",
        "first_name": "SAMSON",
        "middle_name": "GOITOM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "62052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L Taylor, DDS
• Taylor'S Touch of Clarity Mental Health Counseling
• Filmon Kahsay Tekle
• Telemedix Health
• Temis Health Services Inc
• Texas Health Surgery Center Forney, LLC
• Texas Orthodontics for Kids, PC
• Texas Thrive ABA Therapy
• Texas Thrive ABA Therapy
• Texas-One Home Healthcare LLC

• Pharmacist in Forney, TX
• Providers in Forney, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.