Active NPI
John Thalesseril Oommen, PHARM D
- Pharmacist
- Mission, TX
National Provider Identifier
1669637278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64701
- Practice address
- 2314 E Interstate Highway 2
Mission, TX 78572-8685 - Phone
- (965) 585-3990
- NPI assigned
- Jul 23, 2008
- 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 | RP439531 | PA | |
| Pharmacist | 183500000X | 64701 | TX | Primary |
Addresses
Primary practice location
2314 E Interstate Highway 2
Mission, TX 78572-8685
Mailing address
PO Box 638
Brodheadsville, PA 18322
Phone (570) 992-2373
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 |
|---|---|---|---|
| RP439531 | PA | MD | Pharmacist |
| 64701 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1669637278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 638",
"city": "BRODHEADSVILLE",
"state": "PA",
"postal_code": "18322",
"telephone_number": "570-992-2373",
"fax_number": "570-992-2617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2314 E INTERSTATE HIGHWAY 2",
"city": "MISSION",
"state": "TX",
"postal_code": "785728685",
"telephone_number": "965-585-3990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OOMMEN",
"first_name": "JOHN",
"middle_name": "THALESSERIL",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-23",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP439531",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "64701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
- Marta Shaidy Olivarez, RN
- Rebecca Olivarez, M.S.
- Sonia G. Olivarez, COTA
- Nilda Olmeda, FNP-BC
- Oneplus Medical Transportation,LLC
- Optimal Home Health Care LLC
- Optimum Diagnostic Imaging Center (Optimum Imaging Center)
- Optimum Kids LTD (All Around Therapy)
- Optimum Kids LTD (All Around Therapy)
- Optimum Kids LTD (Mission Autism Center & Kids Rehab)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.