Individual provider Active NPI

Edward Phu, PHARMD

  • Pharmacist
  • Haslet, TX
National Provider Identifier
1548860315
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
59674 Issued in TX
Practice address
2401 Avondale Haslet Rd
Haslet, TX 76052-3221
Phone
(817) 302-1731
NPI assigned
Oct 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 59674 TX Primary

Addresses

Primary practice location

2401 Avondale Haslet Rd
Haslet, TX 76052-3221

Mailing address

4513 Stirling Dr
Garland, TX 75043-7220
Phone (832) 818-0382

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
59674TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1548860315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 STIRLING DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750437220",
            "telephone_number": "832-818-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 AVONDALE HASLET RD",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760523221",
            "telephone_number": "817-302-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHU",
        "first_name": "EDWARD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "59674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haslet, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.