Active NPI
Fady Hazboun
- Pharmacist
- Crossroads, TX
National Provider Identifier
1720683477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54017
- Practice address
- 11101 US Highway 380
Crossroads, TX 76227-8203 - Phone
- (940) 365-5762
- NPI assigned
- Dec 1, 2020
- Last updated
- Dec 1, 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 | 54017 | TX | Primary |
Addresses
Primary practice location
11101 US Highway 380
Crossroads, TX 76227-8203
Mailing address
11101 US Highway 380
Crossroads, TX 76227-8203
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | CVSHealth |
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 |
|---|---|---|---|
| 54017 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1720683477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11101 US HIGHWAY 380",
"city": "CROSSROADS",
"state": "TX",
"postal_code": "762278203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11101 US HIGHWAY 380",
"city": "CROSSROADS",
"state": "TX",
"postal_code": "762278203",
"telephone_number": "940-365-5762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZBOUN",
"first_name": "FADY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "54017",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "CVSHealth",
"affiliation": "N",
"address_1": "11101 US Highway 380",
"city": "Crossroads",
"state": "TX",
"country_code": "US",
"postal_code": "762278203",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Crossroads, TX
- Farmstead Speech and Myofunctional PLLC
- Fervent Services Inc
- Sarah Gonzales
- Arielle Jacquelyn Marion Granvold, FNP
- H&P Institute PLLC (Headache and Pain Institute)
- Jonathan Edward Hebda, O.D
- Daniel Raymond Heidrich, CSFA
- Homeline Inc (Life Care Delivered)
- Honey Dental PLLC (Kissable Dental)
- Casey Jamison, WHNP-BC, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.