Individual provider Active NPI

Kelley L Lavallais

  • Pharmacist
  • Pasadena, TX
National Provider Identifier
1063085017
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35277 Issued in TX
Practice address
1802 Strawberry Rd Ste C
Pasadena, TX 77502-2621
Phone
(713) 740-9033
Fax
(713) 740-9044
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35277 TX Primary

Addresses

Primary practice location

1802 Strawberry Rd Ste C
Pasadena, TX 77502-2621

Mailing address

2703 April Cove CT
Manvel, TX 77578-7812
Phone (713) 503-6155

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
35277TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lava Services Inc CurrentSince Jul 25, 2021 Accepting new patients

Locations

1802 Strawberry Rd
Ste C
Pasadena, TX 77502
Phone (713) 740-9033

Organizations & group practices 1

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1063085017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 APRIL COVE CT",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775787812",
            "telephone_number": "713-503-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 STRAWBERRY RD STE C",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775022621",
            "telephone_number": "713-740-9033",
            "fax_number": "713-740-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLAIS",
        "first_name": "KELLEY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "35277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.