Active NPI
Wilson Irabor Ebhohon
- Pharmacist
- Shavano Park, TX
National Provider Identifier
1700489895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65883
- Practice address
- 4100 De Zavala Rd
Shavano Park, TX 78249-2074 - Phone
- (210) 492-9741
- NPI assigned
- Nov 19, 2020
- 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 | 65883 | TX | Primary |
Addresses
Primary practice location
4100 De Zavala Rd
Shavano Park, TX 78249-2074
Mailing address
4100 De Zavala Rd
Shavano Park, TX 78249-2074
Phone (210) 492-9741
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 |
|---|---|---|---|
| 65883 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1700489895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 DE ZAVALA RD",
"city": "SHAVANO PARK",
"state": "TX",
"postal_code": "782492074",
"telephone_number": "210-492-9741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 DE ZAVALA RD",
"city": "SHAVANO PARK",
"state": "TX",
"postal_code": "782492074",
"telephone_number": "210-492-9741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBHOHON",
"first_name": "WILSON",
"middle_name": "IRABOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "65883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shavano Park, TX
- Dianne Dental PLLC (Park Hill Dental)
- Diaz Hospitalist Group PLLC
- Carlos Javier Diaz Velez, MD
- Carmen E Diaz, LPC
- Easy River Counseling and Wellness PLLC
- Eleven Eleven Counseling and Wellness
- Evolve Wellness Center LLC
- Daniela Nazaret Fargason, MD
- Ferruzzi Psychiatric Services, PLLC
- Giancarlo Roberto Ferruzzi, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.