Emmanuel Reynoso

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

40530 Issued in TX

Practice address

1821 S Valley Mills Dr
Waco, TX 76711-2118

Phone

(254) 757-3344

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• H-E-B, LP

  • Community/Retail Pharmacy
  • Waco, TX
  • NPI 1376652719
  NPD
• H-E-B, LP

  • Community/Retail Pharmacy
  • Georgetown, TX
  • NPI 1770393217
  NPD (past)

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1629645700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 S VALLEY MILLS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112118",
            "telephone_number": "254-757-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S VALLEY MILLS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112118",
            "telephone_number": "254-757-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "40530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Dawn Resendez, NNP- BC
• Residency at Ridgewood, LLC
• Humberto Xavier Reveles, MSW, LCSW
• Reweeaks, Inc.
• Erica Marie Reyes-Rosas
• Makala Paige Reynoso
• Jodi Rhines, LCSW
• David H. Rhoden III, DDS
• Christine N Rhodes, MA, LPC
• Miranda Rhodes, MS, RD,LDN

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Waco, TX
• Providers in Waco, TX by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.