Active NPI
Malcolm Miles, RPH
- Pharmacist
- San Antonio, TX
National Provider Identifier
1659686053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46194
- Practice address
- 4821 Broadway St
San Antonio, TX 78209-5703 - Phone
- (210) 824-0515
- NPI assigned
- Aug 10, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46194 | TX | Primary |
| Pharmacist | 183500000X | 6406 | AR |
Addresses
Primary practice location
4821 Broadway St
San Antonio, TX 78209-5703
Mailing address
4821 Broadway St
San Antonio, TX 78209-5703
Phone (210) 824-0515
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6406 | AR | MD | Pharmacist |
| 46194 | TX | MD | Pharmacist |
Practice roles
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1659686053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4821 BROADWAY ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782095703",
"telephone_number": "210-824-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4821 BROADWAY ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782095703",
"telephone_number": "210-824-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "MALCOLM",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "46194",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "6406",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.