Active NPI
Blake Maxson
- Pharmacist
- College Station, TX
National Provider Identifier
1316618077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 58938
- Practice address
- 4421 Highway 6 S Ste 300
College Station, TX 77845-6176 - Phone
- (979) 330-5216
- NPI assigned
- Sep 22, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 58938 | TX | Primary |
Addresses
Primary practice location
4421 Highway 6 S Ste 300
College Station, TX 77845-6176
Mailing address
4421 Highway 6 S Ste 300
College Station, TX 77845-6176
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 |
|---|---|---|---|
| 58938 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632268800000",
"number": "1316618077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4421 HIGHWAY 6 S STE 300",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778456176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4421 HIGHWAY 6 S STE 300",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778456176",
"telephone_number": "979-330-5216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXSON",
"first_name": "BLAKE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-22",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "58938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.