Geodette Sirri Atanga
Individual provider Active NPI Pharmacist · Cisco, TX
NPI 1366223992 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1366223992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 73218 (TX)
- Practice address
- 1010 Avenue E
Cisco, TX 76437-3446 - Phone
- (254) 442-2587
- NPI assigned
- Oct 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73218 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 73218 | TX | Yes |
Addresses
Primary practice location
1010 Avenue E
Cisco, TX 76437-3446
Mailing address
1010 Avenue E
Cisco, TX 76437-3446
Other providers in Cisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.