Active NPI
William Mark Sullivan, R.PH.
- Pharmacist
- Tyler, TX
National Provider Identifier
1447569934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35781
- Practice address
- 807 S Beckham Ave
Tyler, TX 75701-1905 - Phone
- (903) 594-7951
- Fax
- (903) 594-7954
- NPI assigned
- Sep 30, 2010
- 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 | 35781 | TX | Primary |
Addresses
Primary practice location
807 S Beckham Ave
Tyler, TX 75701-1905
Mailing address
807 S Beckham Ave
Tyler, TX 75701-1905
Phone (903) 594-7951
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35781 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1447569934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 S BECKHAM AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757011905",
"telephone_number": "903-594-7951",
"fax_number": "903-594-7954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 S BECKHAM AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757011905",
"telephone_number": "903-594-7951",
"fax_number": "903-594-7954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "WILLIAM",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-30",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "35781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.