Active NPI
Lana Moderow
- Pharmacist
- San Antonio, TX
National Provider Identifier
1306568621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 70756
- Practice address
- 3027 Nacogdoches Rd
San Antonio, TX 78217-4541 - Phone
- (210) 824-5928
- Fax
- (210) 828-9136
- NPI assigned
- Sep 13, 2022
- 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 | 70756 | TX | Primary |
Addresses
Primary practice location
3027 Nacogdoches Rd
San Antonio, TX 78217-4541
Mailing address
3027 Nacogdoches Rd
San Antonio, TX 78217-4541
Phone (210) 824-5928
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 |
|---|---|---|---|
| 70756 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1306568621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3027 NACOGDOCHES RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782174541",
"telephone_number": "210-824-5928",
"fax_number": "210-828-9136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3027 NACOGDOCHES RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782174541",
"telephone_number": "210-824-5928",
"fax_number": "210-828-9136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODEROW",
"first_name": "LANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "70756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
- Shelby Marie Moczygemba, PT, DPT
- Valerie J Moczygemba, LPC
- Modelohz Association
- Modern Dental Professionals San Antonio PC (Castle Dental)
- Modern Optometry PLLC
- Leeann R Modgling, PHARMD
- Joshua Allan Modica, ATC, LAT
- Modk Monitoring PLLC
- Modupeola Adedeji
- Modupeola Olajumoke Adedeji (La Paz Community Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.