Individual provider Active NPI

Paul Lagasse III

  • Pharmacist
  • San Antonio, TX
National Provider Identifier
1689070237
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0012517 Issued in CT
Practice address
5441 Babcock Rd Ste 200
San Antonio, TX 78240-3993
Phone
(210) 253-3847
NPI assigned
Nov 10, 2014
Last updated
Nov 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0012517 CT Primary
Pharmacist 183500000X PH232791 MA

Addresses

Primary practice location

5441 Babcock Rd Ste 200
San Antonio, TX 78240-3993

Mailing address

66 Lantern Hill Rd
Mystic, CT 06355-3611

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

State licenses

LicenseStateTypeSpecialty
PCT.0012517CTMDPharmacist
PH232791MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1689070237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 LANTERN HILL RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 BABCOCK RD STE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403993",
            "telephone_number": "210-253-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASSE",
        "first_name": "PAUL",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0012517",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH232791",
            "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 Nov 10, 2014; 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.