Cynthia Lucia Shores, RPH – Pharmacist in Pecos, TX

Key facts

NPI: 1588264196
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 31922 (TX)
Practice address: 1903 S Cedar St
Pecos, TX 79772-6204
Phone: (432) 445-4255
Fax: (432) 445-4252
NPI assigned: Nov 1, 2020
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Wal-Mart Stores Texas LLC Community/Retail Pharmacy · Pecos, TX · NPI 1376560516

NPD (past)
Wal-Mart Stores Texas, LLC Community/Retail Pharmacy · Melissa, TX · NPI 1386521797

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
31922	TX	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Wal-Mart Stores Texas, LLC		Past since Nov 8, 2020	Accepting new patients
Wal-Mart Stores Texas LLC		Past since Nov 8, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	31922	TX	Yes

Addresses

Primary practice location

1903 S Cedar St
Pecos, TX 79772-6204

Mailing address

212 Cochise Canyon TRL
Fort Davis, TX 79734-4007
Phone (432) 448-0866

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 1, 2020.

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1588264196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 COCHISE CANYON TRL",
            "city": "FORT DAVIS",
            "state": "TX",
            "postal_code": "797344007",
            "telephone_number": "432-448-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S CEDAR ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797726204",
            "telephone_number": "432-445-4255",
            "fax_number": "432-445-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORES",
        "first_name": "CYNTHIA",
        "middle_name": "LUCIA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "31922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pecos, TX

All providers in Pecos, TX · Pharmacist in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.