Active NPI
Deidre D. Kolb
- Pharmacist
- Lufkin, TX
National Provider Identifier
1316969587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 31450
- Practice address
- 1301 West Frank Ave
Lufkin, TX 75904 - Phone
- (936) 633-2735
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- 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 | 31450 | TX | Primary |
Addresses
Primary practice location
1301 West Frank Ave
Lufkin, TX 75904
Mailing address
103 Weber
Diboll, TX 75941
Phone (936) 633-2735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31450 | Other | TX | RPH |
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 |
|---|---|---|---|
| 31450 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316969587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 WEBER",
"city": "DIBOLL",
"state": "TX",
"postal_code": "75941",
"telephone_number": "936-633-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 WEST FRANK AVE",
"city": "LUFKIN",
"state": "TX",
"postal_code": "75904",
"telephone_number": "936-633-2735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLB",
"first_name": "DEIDRE",
"middle_name": "D.",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "31450",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RPH",
"identifier": "31450",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.