Gayland Gene Vandiver, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

21096 Issued in TX

Practice address

101 S Washington Ave
Cleveland, TX 77327-4414

Phone

(281) 592-0491

Fax

(281) 592-0459

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Cleveland, TX
  • NPI 1902084114
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1245315696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274414",
            "telephone_number": "281-592-0491",
            "fax_number": "281-592-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274414",
            "telephone_number": "281-592-0491",
            "fax_number": "281-592-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "GAYLAND",
        "middle_name": "GENE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "21096",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "3846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Tudor, COTA
• Antoine Tyree, PT., OTR/L
• Soren Victor Uhrenholdt, DDS
• Uncle Perry'S LLC, Dba
• Evelyn A Valportodesa
• Susan Michelle Vasquez, APRN, FNP-BC
• VN Creative Care Inc
• VN Creative Care Inc
• Falesha Vonner
• Wakefield Adult Day Jcare Center

• Pharmacist in Cleveland, TX
• Providers in Cleveland, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.