Active NPI
Tito Coomber
- Pharmacy
- Keller, TX
National Provider Identifier
1033718002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 55783
- Practice address
- 976 Keller Pkwy
Keller, TX 76248-3608 - Phone
- (817) 431-5178
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | 55783 | TX | Primary |
Addresses
Primary practice location
976 Keller Pkwy
Keller, TX 76248-3608
Mailing address
976 Keller Pkwy
Keller, TX 76248-3608
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55783 | TX | MD | Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas L P | Pharmacy | Past | Accepting new patients |
| Kroger Texas LP | 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.
-
- Community/Retail Pharmacy
- Keller, TX
- NPI 1649343260
-
- Community/Retail Pharmacy
- Fort Worth, TX
- NPI 1407747439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1033718002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "976 KELLER PKWY",
"city": "KELLER",
"state": "TX",
"postal_code": "762483608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "976 KELLER PKWY",
"city": "KELLER",
"state": "TX",
"postal_code": "762483608",
"telephone_number": "817-431-5178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOMBER",
"first_name": "TITO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-21",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "55783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.