Individual provider Active NPI

Ressah J Abuyedebubinigisiti

  • Pharmacist
  • Eagle Pass, TX
National Provider Identifier
1689859308
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15602 Issued in MD
Practice address
2341 East Main St Walgreens
Eagle Pass, TX 78852
Phone
(800) 879-4471
NPI assigned
Dec 31, 2007
Last updated
Jun 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15602 MD Primary

Addresses

Primary practice location

2341 East Main St Walgreens
Eagle Pass, TX 78852

Mailing address

705 Kingsway Suite 1124
Del Rio, TX 78840
Phone (430) 205-0114

Other names 1

  • Janet Kwende Former name

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
15602MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1689859308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 KINGSWAY SUITE 1124",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "78840",
            "telephone_number": "430-205-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 EAST MAIN ST WALGREENS",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "78852",
            "telephone_number": "800-879-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUYEDEBUBINIGISITI",
        "first_name": "RESSAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-31",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "15602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "KWENDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.