Active NPI
Emmanuel Addo
- Pharmacist
- Mansfield, TX
National Provider Identifier
1225468630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54207
- Practice address
- 3300 E Broad St
Mansfield, TX 76063-5626 - Phone
- (817) 435-5418
- NPI assigned
- Nov 21, 2013
- Last updated
- Jun 12, 2026
- 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 | 54207 | TX | Primary |
Addresses
Primary practice location
3300 E Broad St
Mansfield, TX 76063-5626
Mailing address
3300 E Broad St
Mansfield, TX 76063-5626
Phone (817) 435-5418
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 |
|---|---|---|---|
| 54207 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas LP | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Kroger Texas L P | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 4
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": "1384992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781222400000",
"number": "1225468630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 E BROAD ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760635626",
"telephone_number": "817-435-5418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 E BROAD ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760635626",
"telephone_number": "817-435-5418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDO",
"first_name": "EMMANUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-21",
"last_updated": "2026-06-12",
"certification_date": "2026-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "54207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.