Active NPI
Jared Koyle
- Pharmacist
- Marshall, TX
National Provider Identifier
1447686514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 52992
- Practice address
- 300 E End Blvd N
Marshall, TX 75670-3606 - Phone
- (903) 935-7410
- Fax
- (903) 938-6479
- NPI assigned
- Sep 20, 2013
- Last updated
- Sep 24, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.025790 | LA | |
| Pharmacist | 183500000X | 52992 | TX | Primary |
Addresses
Primary practice location
300 E End Blvd N
Marshall, TX 75670-3606
Mailing address
300 E End Blvd N
Marshall, TX 75670-3606
Phone (903) 935-7410
Other practice location 1
1030 George Dement Blvd
Bossier City, LA 71111-5880
Phone (318) 747-3162
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 |
|---|---|---|---|
| PST.025790 | LA | MD | Pharmacist |
| 52992 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas LP | Past | Accepting new patients | |
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas L P | Past | Accepting new patients |
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": "1379635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1447686514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E END BLVD N",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756703606",
"telephone_number": "903-935-7410",
"fax_number": "903-938-6479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E END BLVD N",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756703606",
"telephone_number": "903-935-7410",
"fax_number": "903-938-6479"
}
],
"practiceLocations": [
{
"address_1": "1030 George Dement Blvd",
"address_purpose": "LOCATION",
"city": "Bossier City",
"state": "LA",
"postal_code": "711115880",
"country_code": "US",
"telephone_number": "318-747-3162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOYLE",
"first_name": "JARED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-20",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.025790",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "52992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.