Active NPI
Ivan Elijah Kitaka, DR.
- Pharmacist
- Houston, TX
National Provider Identifier
1700397338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60548
- Practice address
- 11900 Barryknoll LN Apt 6109
Houston, TX 77024-4388 - Phone
- (832) 934-7998
- NPI assigned
- Oct 23, 2017
- 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 | 60548 | TX | Primary |
Addresses
Primary practice location
11900 Barryknoll LN Apt 6109
Houston, TX 77024-4388
Mailing address
5720 Montclair Hill LN
Rosharon, TX 77583-2032
Phone (713) 363-3661
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60548 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1700397338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 MONTCLAIR HILL LN",
"city": "ROSHARON",
"state": "TX",
"postal_code": "775832032",
"telephone_number": "713-363-3661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11900 BARRYKNOLL LN APT 6109",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770244388",
"telephone_number": "832-934-7998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITAKA",
"first_name": "IVAN",
"middle_name": "ELIJAH",
"name_prefix": "Dr.",
"credential": "DR.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-23",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "60548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.