Active NPI
Casey Marie Wildenborg, PHARMD
- Pharmacist
- Laredo, TX
National Provider Identifier
1205104031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 50503
- Practice address
- 2219 E Saunders St
Laredo, TX 78041-5432 - Phone
- (956) 729-7494
- NPI assigned
- Dec 7, 2011
- Last updated
- Dec 7, 2011
- Sex
- Female
- 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 | 50503 | TX | Primary |
Addresses
Primary practice location
2219 E Saunders St
Laredo, TX 78041-5432
Mailing address
116 Georgia St
Laredo, TX 78041-3136
Phone (956) 285-5869
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50503 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1205104031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 GEORGIA ST",
"city": "LAREDO",
"state": "TX",
"postal_code": "780413136",
"telephone_number": "956-285-5869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2219 E SAUNDERS ST",
"city": "LAREDO",
"state": "TX",
"postal_code": "780415432",
"telephone_number": "956-729-7494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDENBORG",
"first_name": "CASEY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-07",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "50503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.