Active NPI
Daisy Jacquez, PHARMD
- Pharmacist
- Tyler, TX
National Provider Identifier
1134636319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 61895
- Practice address
- 1041 Nne Loop 323
Tyler, TX 75708-2014 - Phone
- (903) 535-7200
- NPI assigned
- Jan 9, 2018
- 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 | 61895 | TX | Primary |
Addresses
Primary practice location
1041 Nne Loop 323
Tyler, TX 75708-2014
Mailing address
1041 Nne Loop 323
Tyler, TX 75708-2014
Phone (903) 535-7200
Other practice location 1
532 Central St
Manchester, NH 03103-3434
Phone (603) 275-3134
Other practice location 2
532 Central St
Manchester, NH 03103-3434
Phone (603) 275-3134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61895 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 61895 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pharmscript of Texas, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Long Term Care Pharmacy
- Tyler, TX
- NPI 1427323005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1134636319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1041 NNE LOOP 323",
"city": "TYLER",
"state": "TX",
"postal_code": "757082014",
"telephone_number": "903-535-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1041 NNE LOOP 323",
"city": "TYLER",
"state": "TX",
"postal_code": "757082014",
"telephone_number": "903-535-7200"
}
],
"practiceLocations": [
{
"address_1": "532 Central St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "NH",
"postal_code": "031033434",
"country_code": "US",
"telephone_number": "603-275-3134",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "532 Central St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "NH",
"postal_code": "031033434",
"country_code": "US",
"telephone_number": "603-275-3134",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACQUEZ",
"first_name": "DAISY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "61895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF PHARMACY",
"identifier": "61895",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.