Active NPI
Kayrah Jack, PHARM D., RPH
- Pharmacist
- Katy, TX
National Provider Identifier
1124630330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58787
- Practice address
- 2720 FM 1463 Rd
Katy, TX 77494-3827 - Phone
- (281) 769-9255
- Fax
- (281) 769-9164
- NPI assigned
- Aug 19, 2020
- 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 | 58787 | TX | Primary |
Addresses
Primary practice location
2720 FM 1463 Rd
Katy, TX 77494-3827
Mailing address
10910 Dawn River CT
Cypress, TX 77433-7161
Phone (832) 740-9241
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58787 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1124630330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10910 DAWN RIVER CT",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774337161",
"telephone_number": "832-740-9241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 FM 1463 RD",
"city": "KATY",
"state": "TX",
"postal_code": "774943827",
"telephone_number": "281-769-9255",
"fax_number": "281-769-9164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACK",
"first_name": "KAYRAH",
"credential": "PHARM D., RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "58787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.