Active NPI
Christopher Brent Panneck, PHARMD
- Pharmacist
- Texarkana, AR
National Provider Identifier
1669236600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD09763
- Practice address
- 3710 N State Line Ave
Texarkana, AR 71854-1934 - Phone
- (870) 774-3146
- NPI assigned
- Feb 9, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD09763 | AR | Primary |
Addresses
Primary practice location
3710 N State Line Ave
Texarkana, AR 71854-1934
Mailing address
141 Maggie Cir
Flint, TX 75762-9521
Phone (870) 974-1502
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD09763 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1669236600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 MAGGIE CIR",
"city": "FLINT",
"state": "TX",
"postal_code": "757629521",
"telephone_number": "870-974-1502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 N STATE LINE AVE",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718541934",
"telephone_number": "870-774-3146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNECK",
"first_name": "CHRISTOPHER",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD09763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.