Alex Park, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

41896 Issued in TX

Practice address

2323 W Front St
Tyler, TX 75702-7704

Phone

(903) 595-3100

Fax

(903) 595-3394

NPI assigned

Apr 28, 2017

Last updated

Apr 28, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1184159097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027704",
            "telephone_number": "903-595-3100",
            "fax_number": "903-595-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027704",
            "telephone_number": "903-595-3100",
            "fax_number": "903-595-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11275",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "52097",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "41896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parent Services Center, Inc.
• Sahil Parikh, DO
• David Stephen Parish, M.D.
• Park Place Tyler HC, LLC (Park Place Nursing & Rehab)
• Park Place Tyler Healthcare, LLC (Park Place Nursing & Rehab)
• Dana Michael Park, M.D.
• Daniel Jun Park, M.D.
• Jung Won Park, DDS
• Parker Health and Chiropractic PA
• Barbara Parker

• Pharmacist in Tyler, TX
• Providers in Tyler, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.