Individual provider Active NPI

Jacob Ottis Pate

  • Pharmacy Technician
  • Lake Jackson, TX
National Provider Identifier
1821765066
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
Practice address
97 Oyster Creek Dr
Lake Jackson, TX 77566-4464
Phone
(979) 299-0105
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X Primary

Addresses

Primary practice location

97 Oyster Creek Dr
Lake Jackson, TX 77566-4464

Mailing address

97 Oyster Creek Dr
Lake Jackson, TX 77566-4464
Phone (979) 299-0105

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

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP PastSince Aug 29, 2021 Accepting new patients

Organizations & group practices 1

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1821765066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 OYSTER CREEK DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664464",
            "telephone_number": "979-299-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 OYSTER CREEK DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664464",
            "telephone_number": "979-299-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "JACOB",
        "middle_name": "OTTIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.