Individual provider Active NPI

Daniel G Kidane, PHARM.D

  • Pharmacist
  • McKinney, TX
National Provider Identifier
1073267555
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
45665 Issued in TX
Practice address
3400 Virginia Pkwy
McKinney, TX 75071-3405
Phone
(214) 250-5006
NPI assigned
Feb 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 45665 TX Primary

Addresses

Primary practice location

3400 Virginia Pkwy
McKinney, TX 75071-3405

Mailing address

10966 Stags Leap CT
Henderson, NV 89052-8738
Phone (617) 285-3106

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1073267555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10966 STAGS LEAP CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890528738",
            "telephone_number": "617-285-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 VIRGINIA PKWY",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750713405",
            "telephone_number": "214-250-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDANE",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "45665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.

Verify at the official NPI Registry.