Active NPI
Jose Lorenzo Castaneda Puno
- Pharmacy
- Dickinson, TX
National Provider Identifier
1053912311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 10648
- Practice address
- 4016 Highway 3
Dickinson, TX 77539-5163 - Phone
- (281) 337-3595
- Fax
- (281) 337-4759
- NPI assigned
- Nov 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67652 | TX | |
| Pharmacy | 333600000X | 10648 | TX | Primary |
Addresses
Primary practice location
4016 Highway 3
Dickinson, TX 77539-5163
Mailing address
12911 Deer Sage CT
Houston, TX 77041-6837
Phone (832) 606-6505
Other practice location 1
1832 Fm 646 Rd W
Dickinson, TX 77539-3202
Phone (281) 614-5785
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4554184 | Other | TX | IT JUST SAYS NON-MEDICARE |
| 462220 | Medicaid | TX |
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 |
|---|---|---|---|
| 67652 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Pharmacy | Past | Accepting new patients |
| Walgreen Co | Pharmacy | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1053912311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12911 DEER SAGE CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770416837",
"telephone_number": "832-606-6505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 HIGHWAY 3",
"city": "DICKINSON",
"state": "TX",
"postal_code": "775395163",
"telephone_number": "281-337-3595",
"fax_number": "281-337-4759"
}
],
"practiceLocations": [
{
"address_1": "1832 Fm 646 Rd W",
"address_purpose": "LOCATION",
"city": "Dickinson",
"state": "TX",
"postal_code": "775393202",
"country_code": "US",
"telephone_number": "281-614-5785",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PUNO",
"first_name": "JOSE LORENZO",
"middle_name": "CASTANEDA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-03",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "67652",
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "10648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IT JUST SAYS NON-MEDICARE",
"identifier": "4554184",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "462220",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dickinson, TX
- Premise Health of Texas Medical, P.a (Galveston Co - Dickinson)
- Ward M Prentice, PA C
- Emily Price
- Primary Health Network of South Texas (Bay Colony Physicians)
- Primary Health Network of South Texas
- Mahalakshmi Ramchandra, M.D.
- Theresa Ann Rameden, MD
- Regency DME, LTD
- Rent an Aide
- Rest Well Sleep & Diagnostics, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.