Individual provider Active NPI

Osamah Fadhil

  • Pharmacist
  • Grand Prairie, TX
National Provider Identifier
1700477361
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68118 Issued in TX
Practice address
4160 La Valse St Apt 3212
Grand Prairie, TX 75052-0244
Phone
(346) 402-8469
NPI assigned
Jan 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 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 68118 TX Primary

Addresses

Primary practice location

4160 La Valse St Apt 3212
Grand Prairie, TX 75052-0244

Mailing address

4160 La Valse St Apt 3212
Grand Prairie, TX 75052-0244
Phone (346) 402-8469

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
68118TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1700477361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 LA VALSE ST APT 3212",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520244",
            "telephone_number": "346-402-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 LA VALSE ST APT 3212",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520244",
            "telephone_number": "346-402-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADHIL",
        "first_name": "OSAMAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "68118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.