Active NPI
Collins Tita
- Pharmacist
- Tyler, TX
National Provider Identifier
1376143396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 56011
- Practice address
- 2151 Frankston Hwy
Tyler, TX 75701-3808 - Phone
- (903) 405-6197
- NPI assigned
- Oct 28, 2020
- Last updated
- Oct 28, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 56011 | TX | Primary |
Addresses
Primary practice location
2151 Frankston Hwy
Tyler, TX 75701-3808
Mailing address
322 Ambrose Ave
Tyler, TX 75704-2028
Phone (713) 552-3982
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
| License | State | Type | Specialty |
|---|---|---|---|
| 56011 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores Texas LLC | Past | Accepting new patients | |
| Wal-Mart Stores Texas, LLC | Past | Accepting new patients |
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.
-
dba Walmart Pharmacy 10-1484
- Community/Retail Pharmacy
- Melissa, TX
- NPI 1386521797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1376143396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 AMBROSE AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757042028",
"telephone_number": "713-552-3982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 FRANKSTON HWY",
"city": "TYLER",
"state": "TX",
"postal_code": "757013808",
"telephone_number": "903-405-6197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITA",
"first_name": "COLLINS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "56011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
- Tinsley & Company, LLP (Omega Home Health)
- Tinsley Associates, LLP (Elara Caring)
- Pat A Tippitt
- Tisbet, LLC (Home Instead Senior Care)
- Maria Teresa Tiscareno, LMSW
- Lionel Buma Tita
- Titan Dental 1 PLLC (Titan Dental)
- Hannah Titlow, RN
- Karlee Tittle
- Titus County Hospital District (Pinecrest Nursing & Rehabilitation Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.