John B Lyon III

Primary specialty

PharmacistTaxonomy code 183500000X

License

28375 Issued in TX

Practice address

14100 RR 12 Unit 2a
Wimberley, TX 78676-5332

Phone

(512) 847-7520

Fax

(512) 842-8032

NPI assigned

Jun 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1376111641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 RR 12 UNIT 2A",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765332",
            "telephone_number": "512-847-7520",
            "fax_number": "512-842-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 RR 12 UNIT 2A",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765332",
            "telephone_number": "512-847-7520",
            "fax_number": "512-842-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "28375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "14100 RR 12 Unit 2A",
            "city": "Wimberley",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786765332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Wimberley, TX
• Providers in Wimberley, TX by specialty
• Pharmacist in Texas

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