NPIMap

Individual provider Active NPI

Bobby Fancher, R.PH.

  • Pharmacist
  • Arlington, TX
National Provider Identifier
1215264346
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24640 Issued in TX
Practice address
100 SE Green Oaks Blvd
Arlington, TX 76018-1640
Phone
(817) 419-0585
Fax
(817) 419-0583
NPI assigned
Nov 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24640 TX Primary

Addresses

Primary practice location

100 SE Green Oaks Blvd
Arlington, TX 76018-1640

Mailing address

100 SE Green Oaks Blvd
Arlington, TX 76018-1640
Phone (817) 419-0585

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
24640TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1215264346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SE GREEN OAKS BLVD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181640",
            "telephone_number": "817-419-0585",
            "fax_number": "817-419-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SE GREEN OAKS BLVD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181640",
            "telephone_number": "817-419-0585",
            "fax_number": "817-419-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANCHER",
        "first_name": "BOBBY",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "24640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.