Active NPI
Jessie Kahlendo Banda, PHARM D
- Pharmacist
- San Antonio, TX
National Provider Identifier
1063741759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 42942
- Practice address
- 20226 Stone Oak Pkwy
San Antonio, TX 78258-6955 - Phone
- (210) 481-9138
- NPI assigned
- Dec 9, 2009
- Last updated
- Aug 7, 2012
- 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 | 42942 | TX | Primary |
Addresses
Primary practice location
20226 Stone Oak Pkwy
San Antonio, TX 78258-6955
Mailing address
20226 Stone Oak Pkwy
San Antonio, TX 78258-6955
Phone (210) 481-9138
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407015597 | 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42942 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344297600000",
"number": "1063741759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20226 STONE OAK PKWY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782586955",
"telephone_number": "210-481-9138",
"fax_number": "210-481-0957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20226 STONE OAK PKWY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782586955",
"telephone_number": "210-481-9138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDA",
"first_name": "JESSIE",
"middle_name": "KAHLENDO",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-09",
"last_updated": "2012-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "42942",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407015597",
"state": "TX"
}
],
"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 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.