Individual provider Active NPI

Connor John Pelzel, PHARM D

  • Pharmacist
  • Gainesville, TX
National Provider Identifier
1194456210
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70195 Issued in TX
Practice address
1201 Olive St
Gainesville, TX 76240-3501
Phone
(940) 668-7384
NPI assigned
Jun 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 70195 TX Primary

Addresses

Primary practice location

1201 Olive St
Gainesville, TX 76240-3501

Mailing address

1201 Olive St
Gainesville, TX 76240-3501
Phone (940) 668-7384

Other practice location 1

310 Charlie Dr
Whitesboro, TX 76273-1103
Phone (903) 564-1234

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
70195TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kiowa Pharmacy, Inc. CurrentSince Nov 24, 2024 Accepting new patients
Wboro Pharmacy LTD Past Accepting new patients
Kiowa Pharmacy, Inc. PastSince Jun 26, 2022 Accepting new patients

Locations

1201 Olive St
Gainesville, TX 76240
Phone (940) 668-7384

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1194456210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 OLIVE ST",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762403501",
            "telephone_number": "940-668-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 OLIVE ST",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762403501",
            "telephone_number": "940-668-7384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Charlie Dr",
            "address_purpose": "LOCATION",
            "city": "Whitesboro",
            "state": "TX",
            "postal_code": "762731103",
            "country_code": "US",
            "telephone_number": "903-564-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELZEL",
        "first_name": "CONNOR",
        "middle_name": "JOHN",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "70195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.