Individual provider Active NPI

Ryan M Dartez, R.PH., MBA

  • Pharmacist
  • Lafayette, LA
National Provider Identifier
1063554574
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15874 Issued in LA
Practice address
509 Jefferson St
Lafayette, LA 70501-6905
Phone
(337) 235-4578
Fax
(337) 235-4570
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15874 LA Primary

Addresses

Primary practice location

509 Jefferson St
Lafayette, LA 70501-6905

Mailing address

332 Mill Pond Dr
Youngsville, LA 70592-5655
Phone (337) 278-3007

Other identifiers 2

IdentifierTypeStateIssuer
1895997MedicaidLA
15874OtherLAPHARMACIST LICENSE

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
Master of Business Administration, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
15874LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Teche Drugs, Inc. Current Accepting new patients
Teche Drugs, Inc. Current Accepting new patients
Pharmacy Business Consulting Pharmacist PastSince Dec 24, 2023 Accepting new patients

Locations

509 Jefferson St
Lafayette, LA 70501
Phone (337) 235-4578

Organizations & group practices 3

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1063554574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 MILL POND DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925655",
            "telephone_number": "337-278-3007",
            "fax_number": "337-235-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 JEFFERSON ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016905",
            "telephone_number": "337-235-4578",
            "fax_number": "337-235-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARTEZ",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "R.PH., MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "15874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1895997",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "15874",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.