Active NPI
Susan Ndukwu
- Pharmacist
- Houston, TX
National Provider Identifier
1255969382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64564
- Practice address
- 13105 Wortham Center Dr
Houston, TX 77065-5611 - Phone
- (713) 442-4055
- Fax
- (713) 442-4058
- NPI assigned
- Apr 1, 2020
- Last updated
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 64564 | TX | Primary |
Addresses
Primary practice location
13105 Wortham Center Dr
Houston, TX 77065-5611
Mailing address
10711 Mason Dale Dr
Cypress, TX 77433-6990
Phone (610) 462-3316
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 |
|---|---|---|---|
| 64564 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1255969382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10711 MASON DALE DR",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774336990",
"telephone_number": "610-462-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13105 WORTHAM CENTER DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770655611",
"telephone_number": "713-442-4055",
"fax_number": "713-442-4058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDUKWU",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TX",
"license": "64564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.