Individual provider Active NPI

Riley Charles Frausto

  • Pharmacist
  • San Antonio, TX
National Provider Identifier
1053923367
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63567 Issued in TX
Practice address
502 New Valley Hi Dr
San Antonio, TX 78227-4394
Phone
(210) 673-0817
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 63567 TX Primary

Addresses

Primary practice location

502 New Valley Hi Dr
San Antonio, TX 78227-4394

Mailing address

8711 Bowens Crossing St Apt 7102
San Antonio, TX 78250-2773
Phone (254) 462-1044

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

LicenseStateTypeSpecialty
63567TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 20, 2022 Accepting new patients
Walgreen Co PastSince Aug 23, 2020 Accepting new patients

Locations

502 New Valley Hi Dr
San Antonio, TX 78227
Phone (210) 673-0817

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1053923367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 BOWENS CROSSING ST APT 7102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782502773",
            "telephone_number": "254-462-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 NEW VALLEY HI DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782274394",
            "telephone_number": "210-673-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAUSTO",
        "first_name": "RILEY",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "63567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.