Individual provider Active NPI

Vicky L Illanne, R.PH.

  • Pharmacist
  • Cypress, TX
National Provider Identifier
1194032987
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30481 Issued in TX
Practice address
24224 Northwest Fwy
Cypress, TX 77429-5683
Phone
(832) 731-1606
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30481 TX Primary

Addresses

Primary practice location

24224 Northwest Fwy
Cypress, TX 77429-5683

Mailing address

24224 Northwest Fwy
Cypress, TX 77429-5683
Phone (832) 731-1606

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

LicenseStateTypeSpecialty
30481TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1194032987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24224 NORTHWEST FWY",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295683",
            "telephone_number": "832-731-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24224 NORTHWEST FWY",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774295683",
            "telephone_number": "832-731-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLANNE",
        "first_name": "VICKY",
        "middle_name": "L",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "30481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.