Active NPI
Stacey Rae Ellison, RPH
- Pharmacist
- Humble, TX
National Provider Identifier
1346637766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33354
- Practice address
- 18215 Yukon Ridge TRL
Humble, TX 77346-4091 - Phone
- (713) 859-0382
- NPI assigned
- Apr 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 33354 | TX | Primary |
Addresses
Primary practice location
18215 Yukon Ridge TRL
Humble, TX 77346-4091
Mailing address
3880 Greenhouse Rd Ste 402
Houston, TX 77084-3486
Phone (713) 859-0382
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33354 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429747200000",
"number": "1346637766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3880 GREENHOUSE RD STE 402",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770843486",
"telephone_number": "713-859-0382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18215 YUKON RIDGE TRL",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464091",
"telephone_number": "713-859-0382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "STACEY",
"middle_name": "RAE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-23",
"last_updated": "2015-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "33354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.