Active NPI
Abisola Tairu, PHARM.D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Shiprock, NM
National Provider Identifier
1093366619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 65714
- Practice address
- US-491
Shiprock, NM 87420 - Phone
- (505) 356-7250
- NPI assigned
- Sep 25, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 65714 | TX | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 65714 | TX | Primary |
Addresses
Primary practice location
US-491
Shiprock, NM 87420
Mailing address
2008 Lanshire Dr
McKinney, TX 75072-2887
Phone (469) 358-8796
Other practice location 1
3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-3270
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | IHSEHR | Other |
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 |
|---|---|---|---|
| 65714 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1093366619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2008 LANSHIRE DR",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750722887",
"telephone_number": "469-358-8796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US-491",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "87420",
"telephone_number": "505-356-7250"
}
],
"practiceLocations": [
{
"address_1": "3601 4th St",
"address_purpose": "LOCATION",
"city": "Lubbock",
"state": "TX",
"postal_code": "794300002",
"country_code": "US",
"telephone_number": "806-743-3270",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAIRU",
"first_name": "ABISOLA",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2021-03-08",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "65714",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "65714",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "IHSEHR",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "NA",
"address_1": "US-491",
"city": "Shiprock",
"state": "NM",
"country_code": "US",
"postal_code": "87420",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Shiprock, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.