Individual provider Active NPI

William R Fat-Anthony

  • Pharmacist
  • Mission, TX
National Provider Identifier
1336454750
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
45974 Issued in TX
Practice address
3401 W Mile 5 Rd
Suite 2
Mission, TX 78574-5313
Phone
(956) 802-4664
Fax
(956) 424-3599
NPI assigned
Aug 10, 2010
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 45D2206609 TX
Durable Medical Equipment & Medical Supplies 332B00000X 28238 TX
Pharmacy 333600000X 28238 TX
Pharmacist 183500000X 45974 TX Primary
Community/Retail Pharmacy 3336C0003X 28238 TX

Addresses

Primary practice location

3401 W Mile 5 Rd
Suite 2
Mission, TX 78574-5313

Mailing address

3401 W Mile 5 Rd
Suite 2
Mission, TX 78574-5313
Phone (956) 802-4664

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

LicenseStateTypeSpecialty
45D2206609TXMDPoint of Service
28238TXMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Mart & DME Durable Medical Equipment & Medical Supplies Current Accepting new patients
Medical Mart & DME Durable Medical Equipment & Medical Supplies Current Accepting new patients

Locations

3401 W Mile 5 Rd
Ste 2
Mission, TX 78574
Phone (956) 424-3535

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1336454750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W MILE 5 RD",
            "address_2": "SUITE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785745313",
            "telephone_number": "956-802-4664",
            "fax_number": "956-424-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W MILE 5 RD",
            "address_2": "SUITE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785745313",
            "telephone_number": "956-802-4664",
            "fax_number": "956-424-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAT-ANTHONY",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "45D2206609",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "28238",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "28238",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "45974",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.