Mario Ray Vallejo, RPH. PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

42737 Issued in TX

Practice address

14300 Horizon Blvd
Horizon City, TX 79928-8527

Phone

(915) 852-1561

Fax

(915) 852-0749

NPI assigned

Nov 15, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Horizon City, TX
  • NPI 1952588469
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258243200000",
    "number": "1780911545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 HORIZON BLVD",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799288527",
            "telephone_number": "915-852-1561",
            "fax_number": "915-852-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 HORIZON BLVD",
            "city": "HORIZON CITY",
            "state": "TX",
            "postal_code": "799288527",
            "telephone_number": "915-852-1561",
            "fax_number": "915-852-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "MARIO",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "RPH. PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-15",
        "last_updated": "2009-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "42737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Villarreal, DPT
• Edmundo Vivanco
• Wal-Mart Stores Texas LLC

• Pharmacist in Horizon City, TX
• Providers in Horizon City, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2009; 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.