Active NPI
Miran Park
- Pharmacist
- Fort Worth, TX
National Provider Identifier
1134724206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44999
- Practice address
- 700 W Seminary Dr
Fort Worth, TX 76115-1340 - Phone
- (817) 920-1750
- NPI assigned
- Dec 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 44999 | TX | Primary |
Addresses
Primary practice location
700 W Seminary Dr
Fort Worth, TX 76115-1340
Mailing address
5009 Toftrees Dr
Arlington, TX 76016-1875
Phone (817) 647-3722
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cvs.com |
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 |
|---|---|---|---|
| 44999 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1134724206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5009 TOFTREES DR",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760161875",
"telephone_number": "817-647-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W SEMINARY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761151340",
"telephone_number": "817-920-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MIRAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "44999",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cvs.com",
"affiliation": "N",
"address_1": "700 W Seminary Dr",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761151340",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.