Elizabeth E Ataboong, RPH

Individual provider Active NPI Pharmacist · Sachse, TX

NPI 1760039150 · NPPES record last updated Aug 21, 2019

Key facts

NPI
1760039150
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
49199 (TX)
Practice address
6750 Murphy Rd
Sachse, TX 75048-2800
Phone
(469) 366-3957
Fax
(469) 366-3944
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
49199TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores Texas, LLC Past
since Aug 25, 2019
Accepting new patients
Wal-Mart Stores Texas LLC Past
since Aug 25, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 49199 TX Yes

Addresses

Primary practice location

6750 Murphy Rd
Sachse, TX 75048-2800

Mailing address

1314 W McDermott Dr Ste 106-530
Allen, TX 75013-3021
Phone (469) 366-3957

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Allen Direct

Other providers in Sachse, TX

All providers in Sachse, TX · Pharmacist in Texas

Sources for this page

Verify at the official NPI Registry.