Ebot Ndemaze Taku, PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

66729 Issued in TX

Practice address

4415 N Stateline Ave
Texarkana, TX 75503-3138

Phone

(240) 704-4117

NPI assigned

May 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1598025454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 SKYLINE BLVD APT 22",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031433",
            "telephone_number": "240-704-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 N STATELINE AVE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033138",
            "telephone_number": "240-704-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKU",
        "first_name": "EBOT",
        "middle_name": "NDEMAZE",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "66729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashli Kay Sutton, LPC
• Kimberly Lynne Sutton, FNP
• Swiftlifttransport
• Synergy Physical Therapy and Rehabilitation, LLC
• Asongtia Taku, PHARMD
• Joshua Nelson Talley, D.M.D
• Rodger Dale Talley, DDS
• Tammie Flanagan Luthringer Physical Therapy and Wellness, LLC
• Jon A Tarpley, MD
• Carol A Tatum, ANP CNS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.