Individual provider Active NPI

Jacob Thyil Palomo

  • Pharmacy
  • Houston, TX
National Provider Identifier
1326626763
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Practice address
5610 W Vistaglen Loop
Houston, TX 77084-2175
Phone
(713) 584-9682
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

5610 W Vistaglen Loop
Houston, TX 77084-2175

Mailing address

5610 W Vistaglen Loop
Houston, TX 77084-2175
Phone (713) 584-9682

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

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1326626763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 W VISTAGLEN LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770842175",
            "telephone_number": "713-584-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 W VISTAGLEN LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770842175",
            "telephone_number": "713-584-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMO",
        "first_name": "JACOB",
        "middle_name": "THYIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Mar 29, 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.