Active NPI
Randy William Cooper
- Pharmacist
- Lubbock, TX
National Provider Identifier
1720679962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24513
- Practice address
- 6104 Avenue Q South Drive
Lubbock, TX 79412 - Phone
- (806) 472-3400
- NPI assigned
- Jan 31, 2021
- 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 | 24513 | NC | Primary |
Addresses
Primary practice location
6104 Avenue Q South Drive
Lubbock, TX 79412
Mailing address
CMR 402 Box 1474
Apo, AE 09180
Phone (314) 590-5222
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 |
|---|---|---|---|
| 24513 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612051200000",
"number": "1720679962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "CMR 402 BOX 1474",
"city": "APO",
"state": "AE",
"postal_code": "09180",
"telephone_number": "314-590-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6104 AVENUE Q SOUTH DRIVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79412",
"telephone_number": "806-472-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "RANDY",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-31",
"last_updated": "2021-01-31",
"certification_date": "2021-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "24513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.