Active NPI
Roberta Jane Hildebrand, R.PH.
- Pharmacist
- Haltom City, TX
National Provider Identifier
1023289972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21002
- Practice address
- 4004 E Belknap St
Haltom City, TX 76111-6609 - Phone
- (817) 834-3001
- Fax
- (817) 834-0710
- NPI assigned
- Mar 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 21002 | TX | Primary |
Addresses
Primary practice location
4004 E Belknap St
Haltom City, TX 76111-6609
Mailing address
6480 Valley Ridge Dr
Fort Worth, TX 76140-9512
Phone (817) 925-7933
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 |
|---|---|---|---|
| 21002 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1023289972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6480 VALLEY RIDGE DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761409512",
"telephone_number": "817-925-7933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4004 E BELKNAP ST",
"city": "HALTOM CITY",
"state": "TX",
"postal_code": "761116609",
"telephone_number": "817-834-3001",
"fax_number": "817-834-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILDEBRAND",
"first_name": "ROBERTA",
"middle_name": "JANE",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "21002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haltom City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.