Raul Elizondo III

Primary specialty

PharmacistTaxonomy code 183500000X

License

63204 Issued in TX

Practice address

100 E FM 495
San Juan, TX 78589-3710

Phone

(956) 283-7880

Fax

(956) 283-0225

NPI assigned

Sep 10, 2020

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• CVS Pharmacy Inc

  dba CVS Pharmacy #17923

  • Pharmacy
  • Stafford, TX
  • NPI 1427931351
  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1629683206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E FM 495",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893710",
            "telephone_number": "956-283-7880",
            "fax_number": "956-283-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E FM 495",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893710",
            "telephone_number": "956-283-7880",
            "fax_number": "956-283-0225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 E Upas Ave",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785019591",
            "country_code": "US",
            "telephone_number": "956-222-4301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "RAUL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "63204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• El Recreo LLC (El Recreo Adult Day Care)
• El Valle Home Health, LLC
• Eleganz Dentistry, PC
• Eleva Enterprises, LLC (Staars)
• Eric Elizondo, OTR
• Kenneth Chiuba Emelonye III
• En Aquellos Tiempos Adc Inc
• En Aquellos Tiempos, Inc.
• Diana Enriquez, CHW
• Elizette Marie Escaname

• Pharmacist in San Juan, TX
• Providers in San Juan, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.