Active NPI
Khafilat Bello
- Pharmacist
- Mansfield, TX
National Provider Identifier
1104406685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66298
- Practice address
- 3145 E Broad St
Mansfield, TX 76063-5602 - Phone
- (817) 453-6000
- NPI assigned
- Apr 9, 2021
- 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 | 66298 | TX | Primary |
Addresses
Primary practice location
3145 E Broad St
Mansfield, TX 76063-5602
Mailing address
7919 Doreen Avenue
Fort Worth, TX 76116
Phone (469) 512-8644
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66298 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1104406685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7919 DOREEN AVENUE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76116",
"telephone_number": "469-512-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3145 E BROAD ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760635602",
"telephone_number": "817-453-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLO",
"first_name": "KHAFILAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-09",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "66298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.