Active NPI
Daxaben J Kothiya
- Pharmacist
- Dallas, TX
National Provider Identifier
1437891165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69947
- Practice address
- 4740 W Mockingbird LN Ste 100B
Dallas, TX 75209-5208 - Phone
- (214) 350-2900
- NPI assigned
- Apr 12, 2022
- Sex
- Female
- 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 | 69947 | TX | Primary |
Addresses
Primary practice location
4740 W Mockingbird LN Ste 100B
Dallas, TX 75209-5208
Mailing address
4740 W Mockingbird LN Ste 100B
Dallas, TX 75209-5208
Phone (214) 350-2900
Other practice location 1
4740 W Mockingbird Ln Ste 100B
Dallas, TX 75209-5208
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 |
|---|---|---|---|
| 69947 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727481600000",
"number": "1437891165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 W MOCKINGBIRD LN STE 100B",
"city": "DALLAS",
"state": "TX",
"postal_code": "752095208",
"telephone_number": "214-350-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 W MOCKINGBIRD LN STE 100B",
"city": "DALLAS",
"state": "TX",
"postal_code": "752095208",
"telephone_number": "214-350-2900"
}
],
"practiceLocations": [
{
"address_1": "4740 W Mockingbird Ln Ste 100B",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752095208",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOTHIYA",
"first_name": "DAXABEN",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-12",
"last_updated": "2024-09-28",
"certification_date": "2024-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "69947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.