Active NPI
Tracie Poe Kadura, R.PH.
- Pharmacist
- Bastrop, TX
National Provider Identifier
1164742235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 38426
- Practice address
- 104 N Hasler Blvd
Bastrop, TX 78602-3740 - Phone
- (512) 581-7044
- Fax
- (512) 332-0422
- NPI assigned
- Jun 10, 2010
- Last updated
- Jun 10, 2010
- 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 | 38426 | TX | Primary |
Addresses
Primary practice location
104 N Hasler Blvd
Bastrop, TX 78602-3740
Mailing address
PO Box 68
Red Rock, TX 78662-0068
Phone (512) 461-9914
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38426 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | 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, 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": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1164742235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 68",
"city": "RED ROCK",
"state": "TX",
"postal_code": "786620068",
"telephone_number": "512-461-9914",
"fax_number": "512-332-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 N HASLER BLVD",
"city": "BASTROP",
"state": "TX",
"postal_code": "786023740",
"telephone_number": "512-581-7044",
"fax_number": "512-332-0422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADURA",
"first_name": "TRACIE",
"middle_name": "POE",
"name_prefix": "Mrs.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-10",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "38426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.