Individual provider Active NPI

Anu Anyan Chackacherry, PHARMD

  • Pharmacist
  • Pasadena, TX
National Provider Identifier
1457956310
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
50405 Issued in TX
Practice address
4010 Fairmont Pkwy
Pasadena, TX 77504-3071
Phone
(281) 998-2303
Fax
(281) 998-2318
NPI assigned
Nov 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 50405 TX Primary

Addresses

Primary practice location

4010 Fairmont Pkwy
Pasadena, TX 77504-3071

Mailing address

13417 Ravens Park LN
Pearland, TX 77584-4061
Phone (832) 713-2076

Other identifiers 1

IdentifierTypeStateIssuer
50405OtherTXTEXAS STATE BOARD OF PHARMACY

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

LicenseStateTypeSpecialty
50405TXMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1457956310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13417 RAVENS PARK LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844061",
            "telephone_number": "832-713-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043071",
            "telephone_number": "281-998-2303",
            "fax_number": "281-998-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKACHERRY",
        "first_name": "ANU",
        "middle_name": "ANYAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "50405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "50405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.