Active NPI
Jerry Shaw, R.PH.
- Pharmacist
- Alvarado, TX
National Provider Identifier
1821452368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23130
- Practice address
- 208 N Parkway Dr
Alvarado, TX 76009-3716 - Phone
- (817) 783-2727
- Fax
- (817) 783-2501
- NPI assigned
- Apr 11, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 23130 | TX | Primary |
Addresses
Primary practice location
208 N Parkway Dr
Alvarado, TX 76009-3716
Mailing address
208 N Parkway Dr
Alvarado, TX 76009-3716
Phone (817) 783-2727
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23130 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460332800000",
"number": "1821452368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 N PARKWAY DR",
"city": "ALVARADO",
"state": "TX",
"postal_code": "760093716",
"telephone_number": "817-783-2727",
"fax_number": "817-783-2501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 N PARKWAY DR",
"city": "ALVARADO",
"state": "TX",
"postal_code": "760093716",
"telephone_number": "817-783-2727",
"fax_number": "817-783-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JERRY",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-11",
"last_updated": "2016-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "23130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alvarado, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.