Active NPI
Theodore Roosevelt Houston
- Pharmacist
- Tallahassee, FL
National Provider Identifier
1174509913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12648
- Practice address
- 855 W Tennessee St
Thagard Health Center, Florida State University
Tallahassee, FL 32304-7834 - Phone
- (850) 644-1015
- Fax
- (850) 654-5570
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- 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 | 12648 | FL | Primary |
Addresses
Primary practice location
855 W Tennessee St
Thagard Health Center, Florida State University
Tallahassee, FL 32304-7834
Mailing address
2404 Mexia Ave
Tallahassee, FL 32304-1321
Phone (850) 576-4929
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 |
|---|---|---|---|
| 12648 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174509913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2404 MEXIA AVE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323041321",
"telephone_number": "850-576-4929",
"fax_number": "850-576-4929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 W TENNESSEE ST",
"address_2": "THAGARD HEALTH CENTER, FLORIDA STATE UNIVERSITY",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323047834",
"telephone_number": "850-644-1015",
"fax_number": "850-654-5570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "THEODORE",
"middle_name": "ROOSEVELT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "12648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.