Individual provider Active NPI

Jesus Roberto Camacho, PHARM. D

  • Pharmacist
  • El Paso, TX
National Provider Identifier
1316612997
Registry record updated Aug 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69039 Issued in TX
Practice address
2950 George Dieter Dr
El Paso, TX 79936-2913
Phone
(915) 856-7040
NPI assigned
Aug 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69039 TX Primary

Addresses

Primary practice location

2950 George Dieter Dr
El Paso, TX 79936-2913

Mailing address

2950 George Dieter Dr
El Paso, TX 79936-2913
Phone (915) 856-7040

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
69039TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1628985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628985600000",
    "number": "1316612997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799362913",
            "telephone_number": "915-856-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799362913",
            "telephone_number": "915-856-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "JESUS",
        "middle_name": "ROBERTO",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-15",
        "last_updated": "2021-08-15",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "69039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.