Cedrick Tsinda Kousok, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

60303 Issued in TX

Practice address

100 SW Wilshire Blvd
Burleson, TX 76028-4712

Phone

(817) 295-1125

Fax

(817) 295-6610

NPI assigned

Oct 31, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• CVS Pharmacy Inc

  • Pharmacy
  • Stafford, TX
  • NPI 1427931351
  NPD (past)
• CVS Pharmacy Inc

  • Pharmacy
  • Burleson, TX
  • NPI 1932203734
  NPD (past)

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1477260586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284712",
            "telephone_number": "817-295-1125",
            "fax_number": "817-295-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284712",
            "telephone_number": "817-295-1125",
            "fax_number": "817-295-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUSOK",
        "first_name": "CEDRICK",
        "middle_name": "TSINDA",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "17452",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "60303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHARMACY",
            "identifier": "60303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF PHARMACY",
            "identifier": "17452",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs7489@cvshealth.com",
            "affiliation": "N",
            "address_1": "100 SW Wilshire Blvd",
            "city": "Burleson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760284712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Rose Kinney, LMSW
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• Sarah Kleinpeter
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• Michelle Krayer, FNP-BC
• Kristen Menzel, LPC
• Kroger Texas L P
• Kuku Nest
• Rohit Kumar, M.D

• Pharmacist in Burleson, TX
• Providers in Burleson, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.