Active NPI
Brian J. Tak, PHARM D
- Ambulatory Care Pharmacist
- Fort Hood, TX
National Provider Identifier
1427547462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 20549
- Practice address
- 36065 Santa Fe Ave
Fort Hood, TX 76544-5060 - Phone
- (254) 553-4365
- NPI assigned
- May 4, 2018
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 20549 | MD | Primary |
Addresses
Primary practice location
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Mailing address
5016 Watercrest Rd Apt 7203
Killeen, TX 76549-6375
Phone (407) 721-3929
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41051775 | Other | TX | DRIVER LICENSE |
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 |
|---|---|---|---|
| 20549 | MD | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525392000000",
"number": "1427547462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5016 WATERCREST RD APT 7203",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765496375",
"telephone_number": "407-721-3929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36065 SANTA FE AVE",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "765445060",
"telephone_number": "254-553-4365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAK",
"first_name": "BRIAN",
"middle_name": "J.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-04",
"last_updated": "2018-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MD",
"license": "20549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "41051775",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.