Active NPI
Michael Prater
- Pharmacist
- Randolph AFB, TX
National Provider Identifier
1740619923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30531
- Practice address
- 221 3Rd St W
BLDG 1040 RM 1D201
Randolph AFB, TX 78150-4800 - Phone
- (210) 652-6741
- NPI assigned
- Nov 7, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 30531 | TX | Primary |
Addresses
Primary practice location
221 3Rd St W
BLDG 1040 RM 1D201
Randolph AFB, TX 78150-4800
Mailing address
221 3Rd St W
BLDG 1040 RM 1D201
Randolph AFB, TX 78150-4800
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 |
|---|---|---|---|
| 30531 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383782400000",
"number": "1740619923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 3RD ST W",
"address_2": "BLDG 1040 RM 1D201",
"city": "RANDOLPH AFB",
"state": "TX",
"postal_code": "781504800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 3RD ST W",
"address_2": "BLDG 1040 RM 1D201",
"city": "RANDOLPH AFB",
"state": "TX",
"postal_code": "781504800",
"telephone_number": "210-652-6741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATER",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-07",
"last_updated": "2013-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "30531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph AFB, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.