Jordan Mills
Individual provider Active NPI Pharmacist · Richland Hills, TX
NPI 1134720030 · NPPES record last updated Nov 5, 2020
Key facts
- NPI
- 1134720030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 55556 (TX)
- Practice address
- 6604 Boulevard 26
Richland Hills, TX 76180-1520 - Phone
- (682) 757-9067
- NPI assigned
- Nov 5, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55556 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores Texas, LLC | Past |
Accepting new patients | |
| Wal-Mart Stores Texas LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 55556 | TX | Yes |
Addresses
Primary practice location
6604 Boulevard 26
Richland Hills, TX 76180-1520
Mailing address
6604 Boulevard 26
Richland Hills, TX 76180-1520
Other providers in Richland Hills, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.