Active NPI
Shady Ayoub
- Pharmacist
- Lubbock, TX
National Provider Identifier
1194584805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73711
- Practice address
- 6420 82ND St
Lubbock, TX 79424-0804 - Phone
- (806) 783-9041
- NPI assigned
- Mar 15, 2024
- Last updated
- Mar 15, 2024
- 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 | 73711 | TX | Primary |
Addresses
Primary practice location
6420 82ND St
Lubbock, TX 79424-0804
Mailing address
6703 82ND St Apt 1216
Lubbock, TX 79424-6761
Phone (806) 544-0622
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 |
|---|---|---|---|
| 73711 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
6420 82nd St
Lubbock, TX 79424
Phone (806) 783-9041
Organizations & group practices 2
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": "1710460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710460800000",
"number": "1194584805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6703 82ND ST APT 1216",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794246761",
"telephone_number": "806-544-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 82ND ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794240804",
"telephone_number": "806-783-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYOUB",
"first_name": "SHADY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-15",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "73711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.