Active NPI
Frederic Robert Watke, PHARMD
- Pharmacist
- Georgetown, TX
National Provider Identifier
1275139743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68004
- Practice address
- 1102 S Austin Ave
Georgetown, TX 78626-6700 - Phone
- (512) 863-2581
- NPI assigned
- Dec 9, 2020
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP454715 | PA | |
| Pharmacist | 183500000X | PHA.0023215 | CO | |
| Pharmacist | 183500000X | PH61090511 | WA | |
| Pharmacist | 183500000X | 68004 | TX | Primary |
Addresses
Primary practice location
1102 S Austin Ave
Georgetown, TX 78626-6700
Mailing address
1102 S Austin Ave
Georgetown, TX 78626-6700
Phone (512) 863-2581
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA.0023215 | CO | MD | Pharmacist |
| RP454715 | PA | MD | Pharmacist |
| 68004 | TX | MD | Pharmacist |
| PH61090511 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| CVS Pharmacy Inc | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1275139743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 S AUSTIN AVE",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786266700",
"telephone_number": "512-863-2581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 S AUSTIN AVE",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786266700",
"telephone_number": "512-863-2581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKE",
"first_name": "FREDERIC",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-09",
"last_updated": "2022-07-08",
"certification_date": "2022-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP454715",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA.0023215",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61090511",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "68004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.