Tinu Elsa Jacob, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

56146 Issued in TX

Practice address

2253 Central Dr
Bedford, TX 76021-5834

Phone

(817) 868-9202

Fax

(817) 868-9207

NPI assigned

Feb 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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
  • Bedford, TX
  • NPI 1831104868
  NPD (past)

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1275925471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9117 SARANAC TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187702",
            "telephone_number": "262-501-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CENTRAL DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215834",
            "telephone_number": "817-868-9202",
            "fax_number": "817-868-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "TINU",
        "middle_name": "ELSA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "56146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahalia L Jackson-Butler, DNP, APRN
• Antonious Dewayne Jackson, D.C., F.N.P-C
• Ryan C Jackson, MD
• Sharon L Jackson, MD
• Stacey Jackson, FNP-C
• Janus Long Jacobs, FNP
• Banny Jasmine Jaen
• Enilse Jaen
• Desoree James
• Jerry James, PHARMD, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.