Active NPI
Idorenyin Aniefiok Etuk
- Pharmacotherapy Pharmacist
- Sugar Land, TX
National Provider Identifier
1265915284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 73727
- Practice address
- 530 Highway 6
Sugar Land, TX 77478-4947 - Phone
- (281) 240-6370
- Fax
- (866) 494-7449
- NPI assigned
- Sep 14, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73727 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pharmacotherapy Pharmacist | 1835P1200X | 73727 | TX | Primary |
Addresses
Primary practice location
530 Highway 6
Sugar Land, TX 77478-4947
Mailing address
329 Grand Isle LN
Dickinson, TX 77539-4055
Phone (713) 349-4091
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 |
|---|---|---|---|
| 73727 | TX | MD | Professional Counselor |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741910400000",
"number": "1265915284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 GRAND ISLE LN",
"city": "DICKINSON",
"state": "TX",
"postal_code": "775394055",
"telephone_number": "713-349-4091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 HIGHWAY 6",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774784947",
"telephone_number": "281-240-6370",
"fax_number": "866-494-7449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETUK",
"first_name": "IDORENYIN",
"middle_name": "ANIEFIOK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-14",
"last_updated": "2025-03-14",
"certification_date": "2025-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "73727",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "TX",
"license": "73727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.