Individual provider Active NPI

Careen Elizabeth Fullerton, PHARM D.

  • Pharmacist
  • Pollok, TX
National Provider Identifier
1417397936
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
53171 Issued in TX
Practice address
6844 N US Highway 69
Pollok, TX 75969-4548
Phone
(936) 853-8804
NPI assigned
Jun 28, 2013
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 53171 TX Primary

Addresses

Primary practice location

6844 N US Highway 69
Pollok, TX 75969-4548

Mailing address

212 Green MDWS
Lufkin, TX 75904-5538
Phone (830) 456-6180

Other names 1

  • Careen Elizabeth Lemeilleur Former name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
53171TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1417397936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 GREEN MDWS",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045538",
            "telephone_number": "830-456-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6844 N US HIGHWAY 69",
            "city": "POLLOK",
            "state": "TX",
            "postal_code": "759694548",
            "telephone_number": "936-853-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "CAREEN",
        "middle_name": "ELIZABETH",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "53171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREEN",
            "last_name": "LEMEILLEUR",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pollok, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.