Individual provider Active NPI

Manoj Mohanlal, R.PH

  • Pharmacist
  • Richardson, TX
National Provider Identifier
1740517333
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35926 Issued in TX
Practice address
500 Centennial Blvd
Richardson, TX 75081-5147
Phone
(972) 231-2235
Fax
(972) 231-2415
NPI assigned
Nov 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35926 TX Primary

Addresses

Primary practice location

500 Centennial Blvd
Richardson, TX 75081-5147

Mailing address

500 Centennial Blvd
Richardson, TX 75081-5147
Phone (972) 231-2235

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
35926TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients

Locations

500 Centennial Blvd
Richardson, TX 75081
Phone (972) 231-2235

Organizations & group practices 2

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1740517333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CENTENNIAL BLVD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815147",
            "telephone_number": "972-231-2235",
            "fax_number": "972-231-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CENTENNIAL BLVD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815147",
            "telephone_number": "972-231-2235",
            "fax_number": "972-231-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANLAL",
        "first_name": "MANOJ",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "35926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.