Active NPI
Haivan Immler, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Fort Worth, TX
National Provider Identifier
1326628256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 68270
- Practice address
- 6601 Harris Pkwy
Fort Worth, TX 76132-6108 - Phone
- (817) 433-9600
- Fax
- (888) 593-8498
- NPI assigned
- Apr 13, 2021
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 68270 | TX | Primary |
Addresses
Primary practice location
6601 Harris Pkwy
Fort Worth, TX 76132-6108
Mailing address
700 Essex CT
Southlake, TX 76092-7119
Phone (682) 365-3836
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68270 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1326628256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 ESSEX CT",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927119",
"telephone_number": "682-365-3836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 HARRIS PKWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761326108",
"telephone_number": "817-433-9600",
"fax_number": "888-593-8498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMLER",
"first_name": "HAIVAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "68270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.