Justin Lynn Vardeman

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

266270 Issued in TX

Practice address

97 Oyster Creek Dr
Lake Jackson, TX 77566-4464

Phone

(979) 299-0105

NPI assigned

Jan 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• H-E-B, LP

  • Community/Retail Pharmacy
  • Lake Jackson, TX
  • NPI 1306243035
  NPD (past)

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1366031395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 OYSTER CREEK DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664464",
            "telephone_number": "979-299-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 OYSTER CREEK DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664464",
            "telephone_number": "979-299-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDEMAN",
        "first_name": "JUSTIN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TX",
            "license": "266270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TX-Therapy LLC
• Lindsey Tyler
• U S Anesthesia Partners of Texas
• U S Anesthesia Partners of Texas, PA
• Brandy Vandergrifft, APRN, FNP-C
• Robert Varela
• Juan Vargas
• Mariam V Varghese
• Sherry G Varner, P.T.
• Charles Vega, M.D.

• Pharmacy Technician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Pharmacy Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.