Active NPI
Avery Rae Queen, PHARM.D.
- Pharmacist
- Temple, TX
National Provider Identifier
1417640673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39242
- Practice address
- 3002 S 31St St
Temple, TX 76502-1802 - Phone
- (254) 773-2177
- NPI assigned
- Jun 1, 2023
- 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 | 39242 | TX | Primary |
Addresses
Primary practice location
3002 S 31St St
Temple, TX 76502-1802
Mailing address
8024 Hawthorn
Temple, TX 76502-5592
Phone (210) 445-1422
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39242 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1417640673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8024 HAWTHORN",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765025592",
"telephone_number": "210-445-1422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3002 S 31ST ST",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021802",
"telephone_number": "254-773-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "AVERY",
"middle_name": "RAE",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-01",
"last_updated": "2023-07-24",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "39242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.