Active NPI
Kristi Ann Kubosh, PHARMD
- Pharmacist
- Dallas, TX
National Provider Identifier
1508403973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 48761
- Practice address
- 4941 Reiger Ave
Dallas, TX 75214-5422 - Phone
- (979) 218-4735
- NPI assigned
- Dec 4, 2019
- Sex
- Female
- 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 | 48761 | TX | Primary |
Addresses
Primary practice location
4941 Reiger Ave
Dallas, TX 75214-5422
Mailing address
4941 Reiger Ave
Dallas, TX 75214-5422
Phone (979) 218-4735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48761 | Other | TX | TEXAS PHARMACIST LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 48761 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kak Healthcare, LLC | Current | Accepting new patients | |
| KK & SS Healthcare Investments, LLC | Current | 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.
-
dba Pharm House Drug- Trinity LLC
- Community/Retail Pharmacy
- Trinity, TX
- NPI 1497254544
-
dba Pharm House Drug - Sonora LLC
- Community/Retail Pharmacy
- Sonora, TX
- NPI 1598273989
-
dba Pharm House Drug - La Grange, LLC.
- Community/Retail Pharmacy
- La Grange, TX
- NPI 1588162960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1508403973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4941 REIGER AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752145422",
"telephone_number": "979-218-4735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4941 REIGER AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752145422",
"telephone_number": "979-218-4735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBOSH",
"first_name": "KRISTI",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-04",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "48761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS PHARMACIST LICENSE",
"identifier": "48761",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.