Active NPI
Friday Edorodion Ajayi
- Pharmacist
- Dyess Afb, TX
National Provider Identifier
1619600277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66366
- Practice address
- 697 Louisiana Rd
Dyess Afb, TX 79607-1141 - Phone
- (325) 696-4677
- NPI assigned
- Jul 1, 2022
- Sex
- Male
- 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 | 66366 | TX | Primary |
Addresses
Primary practice location
697 Louisiana Rd
Dyess Afb, TX 79607-1141
Mailing address
734 Kensington LN
Mansfield, TX 76063-2819
Phone (817) 881-9662
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 |
|---|---|---|---|
| 66366 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1619600277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "734 KENSINGTON LN",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760632819",
"telephone_number": "817-881-9662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "697 LOUISIANA RD",
"city": "DYESS AFB",
"state": "TX",
"postal_code": "796071141",
"telephone_number": "325-696-4677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJAYI",
"first_name": "FRIDAY",
"middle_name": "EDORODION",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-01",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "66366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyess Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.