Russell Krenek

Primary specialty

PharmacistTaxonomy code 183500000X

License

37833 Issued in TX

Practice address

5415 S Broadway Ave
Tyler, TX 75703-1397

Phone

(903) 939-9298

NPI assigned

Dec 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Tyler, TX
  • NPI 1679588669
  NPD (past)

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1104155597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031397",
            "telephone_number": "903-939-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031397",
            "telephone_number": "903-939-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRENEK",
        "first_name": "RUSSELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "37833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Kramp
• Caleb Krause
• Suzanne C Krause, MA CCC SLP
• Kimberley Krauter
• Jake H Kreck, P.A.-C
• Dennis Michael Kress, PTA
• Nicholas Kreyling, DO
• Wilson Lee Krezdorn, PHARM.D.
• Teresa Kriechbaum
• Benjamin John Krog, MD

• All providers in Tyler, TX
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.