Individual provider Active NPI

Chris M Kotaska, PHARMD

  • Pharmacist
  • Allen, TX
National Provider Identifier
1619571569
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37305 Issued in TX
Practice address
1540 E Main St
Allen, TX 75002-4486
Phone
(214) 383-9765
Fax
(214) 383-9771
NPI assigned
Nov 22, 2020
Last updated
Nov 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 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 37305 TX Primary

Addresses

Primary practice location

1540 E Main St
Allen, TX 75002-4486

Mailing address

5903 Wessex CT
Allen, TX 75002-5455
Phone (214) 563-5417

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
37305TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1619571569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5903 WESSEX CT",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750025455",
            "telephone_number": "214-563-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E MAIN ST",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750024486",
            "telephone_number": "214-383-9765",
            "fax_number": "214-383-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTASKA",
        "first_name": "CHRIS",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "37305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.