Active NPI
Shawyan Dadari
- Pharmacist
- Austin, TX
National Provider Identifier
1417509837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64786
- Practice address
- 3701 Guadalupe St Ste 102
Austin, TX 78705-1330 - Phone
- (512) 354-3696
- NPI assigned
- Jul 16, 2019
- Last updated
- Apr 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 64786 | TX | Primary |
Addresses
Primary practice location
3701 Guadalupe St Ste 102
Austin, TX 78705-1330
Mailing address
3701 Guadalupe St Ste 102
Austin, TX 78705-1330
Phone (512) 354-3696
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 |
|---|---|---|---|
| 64786 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3701 Guadalupe St
Ste 102
Austin, TX 78705
Phone (512) 354-3696
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1417509837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 GUADALUPE ST STE 102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051330",
"telephone_number": "512-354-3696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 GUADALUPE ST STE 102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051330",
"telephone_number": "512-354-3696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DADARI",
"first_name": "SHAWYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-16",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "64786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.