Active NPI
Mary Jo Treadway, RPH
- Pharmacist
- Coppell, TX
National Provider Identifier
1619204369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23046
- Practice address
- 313 N Denton Tap Rd
Coppell, TX 75019-2914 - Phone
- (972) 393-9848
- NPI assigned
- Nov 17, 2009
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23046 | TX | Primary |
Addresses
Primary practice location
313 N Denton Tap Rd
Coppell, TX 75019-2914
Mailing address
313 N Denton Tap Rd
Coppell, TX 75019-2914
Phone (972) 393-9848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23046 | Other | TX | PHARMACIST LICENSE NO |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23046 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, 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": "1258416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1619204369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 N DENTON TAP RD",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192914",
"telephone_number": "972-393-9848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 N DENTON TAP RD",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192914",
"telephone_number": "972-393-9848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREADWAY",
"first_name": "MARY",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-17",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "23046",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NO",
"identifier": "23046",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
- Town Center ER, Inc.
- Town Center ER, Inc.
- Traditional Holistic Wellness,LLC (Points of Health Acupuncture & Herbal Medicine)
- Tranquility Dental, PLLC
- Transformation Physical Therapy LLC
- Triton Integrated Care PLLC
- Cindy Truong
- Kiet Tuan Truong, M.D.
- Hadley Arden Turner, MSOTR/L
- Lea Ann Tutt, DENTAL HYGIENIST
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.