Active NPI
Modupe Olatokunbo Soyombo, PHARM D
- Pharmacist
- Baytown, TX
National Provider Identifier
1780040444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54663
- Practice address
- 4849 N Highway 146
Baytown, TX 77520-8700 - Phone
- (281) 420-9827
- NPI assigned
- Jan 12, 2016
- Last updated
- Jan 12, 2016
- Sex
- Female
- 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 | 54663 | TX | Primary |
Addresses
Primary practice location
4849 N Highway 146
Baytown, TX 77520-8700
Mailing address
9955 Buffalo Speedway Apt 5204
Houston, TX 77054-1325
Phone (832) 633-1979
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54663 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1780040444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9955 BUFFALO SPEEDWAY APT 5204",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770541325",
"telephone_number": "832-633-1979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4849 N HIGHWAY 146",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775208700",
"telephone_number": "281-420-9827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOYOMBO",
"first_name": "MODUPE",
"middle_name": "OLATOKUNBO",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-12",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "54663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baytown, TX
- Candace Southall, LPC
- Southeast Texas Institute of Pain Managementp.a
- Southern Pain Institute (Texas Pain Institute)
- Southwest Diagnostics
- Southwest Orthopedic Group, LLP
- Special Texas Home Inc (Burning Tree Living Center)
- Special Texas Homes Inc (Olive Living Center)
- Special Texas Homes Inc (Maplewood Living Center)
- Special Texas Homes, Inc. (Olive Living Center)
- Special Texas Homes, Inc. (Burning Tree Living Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.