Individual provider Active NPI

Isaac Kwame Agyare, RPH

  • Pharmacist
  • Lufkin, TX
National Provider Identifier
1831732718
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
39793 Issued in TX
Practice address
1522 West Frank Ave. Room 127
Lufkin, TX 75904
Phone
(936) 637-4139
Fax
(936) 637-0046
NPI assigned
Oct 23, 2019
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39793 TX Primary

Addresses

Primary practice location

1522 West Frank Ave. Room 127
Lufkin, TX 75904

Mailing address

1522 West Frank Ave. Room 127
Lufkin, TX 75904
Phone (936) 637-4139

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

LicenseStateTypeSpecialty
39793TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC CurrentSince Mar 22, 2020 Accepting new patients
Genoa Healthcare LLC PastSince Oct 27, 2019 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": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1831732718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 WEST FRANK AVE. ROOM 127",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-637-4139",
            "fax_number": "936-637-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 WEST FRANK AVE. ROOM 127",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-637-4139",
            "fax_number": "936-637-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGYARE",
        "first_name": "ISAAC",
        "middle_name": "KWAME",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "39793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.