Individual provider Active NPI

Dale Wayne Anderson, R.PH.

  • Pharmacist
  • Sherman, TX
National Provider Identifier
1104110220
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27701 Issued in TX
Practice address
4160 Town Ctr
T-1861
Sherman, TX 75092-2567
Phone
(903) 892-4416
Fax
(903) 892-4416
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27701 TX Primary

Addresses

Primary practice location

4160 Town Ctr
T-1861
Sherman, TX 75092-2567

Mailing address

4160 Town Ctr
T-1861
Sherman, TX 75092-2567
Phone (903) 892-4416

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
27701TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1104110220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 TOWN CTR",
            "address_2": "T-1861",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750922567",
            "telephone_number": "903-892-4416",
            "fax_number": "903-892-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 TOWN CTR",
            "address_2": "T-1861",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750922567",
            "telephone_number": "903-892-4416",
            "fax_number": "903-892-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DALE",
        "middle_name": "WAYNE",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "27701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.