NPIMap

Organization Active NPI

De Angelo Pharmacy Inc

Doing business as DeAngelo Pharmacy

  • Community/Retail Pharmacy
  • La Porte, TX
National Provider Identifier
1295004067
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
27817 Issued in TX
Legal business name
DE ANGELO PHARMACY INC
Doing business as
DeAngelo Pharmacy
Practice address
112 Hwy 146 S
Suite B
La Porte, TX 77571-6123
Phone
(281) 842-8500
Fax
(281) 842-8505
NPI assigned
Dec 22, 2011
Last updated
Jul 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Angelique Dede Norris, RPHNPI 1285209395
Title
Pic
Phone
(281) 842-8500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 27817 TX Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

112 Hwy 146 S
Suite B
La Porte, TX 77571-6123

Mailing address

112 Hwy 146 South
Ste B
La Porte, TX 77571-6123
Phone (281) 842-8500

Other identifiers 2

IdentifierTypeStateIssuer
2133251OtherPK
146532MedicaidTX

Other names 1

  • DeAngelo Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1309 W Fairmont Pkwy
Ste P
La Porte, TX 77571
Phone (281) 842-8500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1295004067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HWY 146 SOUTH",
            "address_2": "STE B",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716123",
            "telephone_number": "281-842-8500",
            "fax_number": "281-842-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HWY 146 S",
            "address_2": "SUITE B",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716123",
            "telephone_number": "281-842-8500",
            "fax_number": "281-842-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE ANGELO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_middle_name": "DEDE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "281-842-8500",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27817",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133251",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146532",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeAngelo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DeAngelo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Porte, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.