Active NPI
Michaela Lynn McLeod
- Pharmacist
- Crockett, TX
National Provider Identifier
1619694908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71522
- Practice address
- 107 S 4TH St
Crockett, TX 75835-2024 - Phone
- (936) 544-2275
- NPI assigned
- Oct 26, 2022
- Last updated
- Oct 26, 2022
- 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 | 71522 | TX | Primary |
Addresses
Primary practice location
107 S 4TH St
Crockett, TX 75835-2024
Mailing address
107 S 4TH St
Crockett, TX 75835-2024
Phone (936) 544-2275
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 |
|---|---|---|---|
| 71522 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1619694908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S 4TH ST",
"city": "CROCKETT",
"state": "TX",
"postal_code": "758352024",
"telephone_number": "936-544-2275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 S 4TH ST",
"city": "CROCKETT",
"state": "TX",
"postal_code": "758352024",
"telephone_number": "936-544-2275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEOD",
"first_name": "MICHAELA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "71522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crockett, TX
- John A. McCall Jr., OD
- Matthew Ream McCall, OD
- McDonald Family Health Center LLC
- Toni Loraine McDonald, M.S.N., R.N., F.N.P.
- Michael R McLeod, M.D.
- Robert Keith McLeod
- Tim Meyer, PA
- Mid Coast Medical Center Crockett Inc (Crockett Medical Center Clinic)
- Mid Coast Medical Center Crockett Inc (Crockett Medical Center)
- Ray L Morrison, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.