Active NPI
Juan Pablo Resendez, R.PH.
- Community/Retail Pharmacy
- Brownsville, TX
National Provider Identifier
1457511370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 16854
- Practice address
- 1740 Boca Chica Blvd
Suite 400
Brownsville, TX 78520-8132 - Phone
- (956) 550-0632
- Fax
- (956) 541-4007
- NPI assigned
- Jun 13, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 31400 | TX | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 16854 | TX | Primary |
Addresses
Primary practice location
1740 Boca Chica Blvd
Suite 400
Brownsville, TX 78520-8132
Mailing address
1740 Boca Chica Blvd
Suite 400
Brownsville, TX 78520-8132
Phone (956) 550-0632
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4596081 | Other | TX | NCPDP |
| 74-2765978 | Other | FEDERAL TAX ID (IRS#) | |
| 144372 | Medicaid | TX |
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 |
|---|---|---|---|
| 31400 | TX | MD | Pharmacist |
| 16854 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273104000000",
"number": "1457511370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 BOCA CHICA BLVD",
"address_2": "SUITE 400",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785208132",
"telephone_number": "956-550-0632",
"fax_number": "956-541-4007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 BOCA CHICA BLVD",
"address_2": "SUITE 400",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785208132",
"telephone_number": "956-550-0632",
"fax_number": "956-541-4007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESENDEZ",
"first_name": "JUAN",
"middle_name": "PABLO",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-13",
"last_updated": "2010-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "31400",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "16854",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "4596081",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID (IRS#)",
"identifier": "74-2765978",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144372",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.