Active NPI
Adise Marie Roubleau, PHARM D
- Pharmacist
- La Porte, TX
National Provider Identifier
1033499694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39644
- Practice address
- 9705 W Main St
La Porte, TX 77571-4071 - Phone
- (281) 470-7428
- NPI assigned
- Aug 26, 2011
- Last updated
- Aug 26, 2011
- 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 | 39644 | TX | Primary |
Addresses
Primary practice location
9705 W Main St
La Porte, TX 77571-4071
Mailing address
3016 Woodwren CT
League City, TX 77573-5943
Phone (713) 416-5421
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39644 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1033499694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3016 WOODWREN CT",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775735943",
"telephone_number": "713-416-5421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9705 W MAIN ST",
"city": "LA PORTE",
"state": "TX",
"postal_code": "775714071",
"telephone_number": "281-470-7428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUBLEAU",
"first_name": "ADISE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "39644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Porte, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.