Active NPI
Traci Lynn Brannon, PHARM D
- Pharmacist
- Decatur, TX
National Provider Identifier
1043858723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45516
- Practice address
- 800 S Highway 287
Decatur, TX 76234-1656 - Phone
- (940) 627-3038
- NPI assigned
- Dec 13, 2019
- 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 | 45516 | TX | Primary |
Addresses
Primary practice location
800 S Highway 287
Decatur, TX 76234-1656
Mailing address
273 County Road 1170
Decatur, TX 76234-6217
Phone (940) 577-4845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45516 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 45516 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1043858723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 COUNTY ROAD 1170",
"city": "DECATUR",
"state": "TX",
"postal_code": "762346217",
"telephone_number": "940-577-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S HIGHWAY 287",
"city": "DECATUR",
"state": "TX",
"postal_code": "762341656",
"telephone_number": "940-627-3038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANNON",
"first_name": "TRACI",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-13",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "45516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF PHARMACY",
"identifier": "45516",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.