Active NPI
Lisa Angel Sandoval
- Pharmacy Technician
- Corpus Christi, TX
National Provider Identifier
1609442938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 100083
- Practice address
- 4444 Kostoryz Rd
Corpus Christi, TX 78415-5021 - Phone
- (361) 855-6121
- NPI assigned
- May 27, 2021
- Last updated
- May 27, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 100083 | TX | Primary |
Addresses
Primary practice location
4444 Kostoryz Rd
Corpus Christi, TX 78415-5021
Mailing address
4444 Kostoryz Rd
Corpus Christi, TX 78415-5021
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NA | ||
| CONNECT URL | NA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100083 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1609442938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 KOSTORYZ RD",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 KOSTORYZ RD",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155021",
"telephone_number": "361-855-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "LISA",
"middle_name": "ANGEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "TX",
"license": "100083",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"address_1": "4444 Kostoryz Rd",
"city": "Corpus Christi",
"state": "TX",
"country_code": "US",
"postal_code": "784155021",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"address_1": "4444 Kostoryz Rd",
"city": "Corpus Christi",
"state": "TX",
"country_code": "US",
"postal_code": "784155021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.