Individual provider Active NPI

Jerry Fu, PHARMD

  • Pharmacist
  • Houston, TX
National Provider Identifier
1306568670
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
49339 Issued in TX
Practice address
415 Westheimer Rd Ste 103
Houston, TX 77006-3058
Phone
(281) 498-1450
NPI assigned
Sep 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 49339 TX Primary

Addresses

Primary practice location

415 Westheimer Rd Ste 103
Houston, TX 77006-3058

Mailing address

415 Westheimer Rd Ste 103
Houston, TX 77006-3058
Phone (281) 498-1450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address operations@southendpharmacystore.com Direct

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

LicenseStateTypeSpecialty
49339TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Max Incorporated Pharmacist CurrentSince Sep 20, 2022 Accepting new patients

Locations

415 Westheimer Rd
Ste 103
Houston, TX 77006
Phone (281) 498-1450

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1306568670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 WESTHEIMER RD STE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770063058",
            "telephone_number": "281-498-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WESTHEIMER RD STE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770063058",
            "telephone_number": "281-498-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "JERRY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "49339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "operations@southendpharmacystore.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "415 Westheimer Rd Ste 103",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770063058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.