Individual provider Active NPI

Jeffrey Anthony Fabiano

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Burleson, TX
National Provider Identifier
1801427083
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
35801 Issued in TX
Practice address
1631 SW Wilshire Blvd
Burleson, TX 76028-6305
Phone
(817) 258-5952
NPI assigned
Jan 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 35801 TX Primary

Addresses

Primary practice location

1631 SW Wilshire Blvd
Burleson, TX 76028-6305

Mailing address

1631 SW Wilshire Blvd
Burleson, TX 76028-6305
Phone (817) 258-5952

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

LicenseStateTypeSpecialty
35801TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Texas LP PastSince Feb 2, 2020 Accepting new patients
Kroger Texas L P PastSince Feb 2, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1801427083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286305",
            "telephone_number": "817-258-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286305",
            "telephone_number": "817-258-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIANO",
        "first_name": "JEFFREY",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "35801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.