Khaled Kotb

Primary specialty

PharmacistTaxonomy code 183500000X

License

69992 Issued in TX

Practice address

3411 Custer Pkwy
Richardson, TX 75080-1012

Phone

(972) 470-1372

NPI assigned

Feb 7, 2022

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

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.

• Randalls Food & Drugs LP

  dba Tom Thumb Pharmacy #0361

  • Community/Retail Pharmacy
  • Sanger, TX
  • NPI 1730052747
  NPD (past)
• Randalls Food & Drugs LP

  dba Tom Thumb Pharmacy #3641

  • Community/Retail Pharmacy
  • Richardson, TX
  • NPI 1962433789
  NPD (past)

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1649924986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 CUSTER PKWY APT D",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801628",
            "telephone_number": "347-702-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 CUSTER PKWY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801012",
            "telephone_number": "972-470-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTB",
        "first_name": "KHALED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "69992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Koriakos, DO
• Karen D Kornelsen, LPC INTERN
• Divya Korrapati
• McKenzie Marie Koshi
• Suja Koshy, PTA
• Niharika Kothapalli
• Shannon Nicole Kouser, LPC
• McKailah Kovar
• Cassie J Krajack
• Julia Madison Krantz, CNIM

• Pharmacist in Richardson, TX
• Providers in Richardson, TX by specialty
• Pharmacist in Texas

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

Verify at the official NPI Registry.