Active NPI
Karissa Aira Tismo Coluso
- Pharmacist
- Wichita Falls, TX
National Provider Identifier
1407476260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66112
- Practice address
- 2700 Central Fwy
Wichita Falls, TX 76306-2843 - Phone
- (940) 855-2374
- NPI assigned
- Apr 22, 2020
- Last updated
- Apr 22, 2020
- Sex
- Female
- 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 | 66112 | TX | Primary |
Addresses
Primary practice location
2700 Central Fwy
Wichita Falls, TX 76306-2843
Mailing address
2700 Central Fwy
Wichita Falls, TX 76306-2843
Phone (940) 855-2374
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66112 | Other | TX | TEXAS BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 66112 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1407476260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 CENTRAL FWY",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763062843",
"telephone_number": "940-855-2374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 CENTRAL FWY",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763062843",
"telephone_number": "940-855-2374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLUSO",
"first_name": "KARISSA AIRA",
"middle_name": "TISMO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-22",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "66112",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BOARD OF PHARMACY",
"identifier": "66112",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.