Active NPI
Melvin Jerome Roberts Jr., PHARMD, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Beaumont, TX
National Provider Identifier
1831739036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 55667
- Practice address
- 3845 Phelan Blvd
Beaumont, TX 77707-2243 - Phone
- (409) 833-4437
- NPI assigned
- Jan 15, 2020
- Last updated
- Jan 15, 2020
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 55667 | TX | Primary |
Addresses
Primary practice location
3845 Phelan Blvd
Beaumont, TX 77707-2243
Mailing address
2425 Holly Hall St Apt B40
Houston, TX 77054-3991
Phone (713) 392-6561
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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55667 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas LP | Past | 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": "1579046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1831739036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 HOLLY HALL ST APT B40",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770543991",
"telephone_number": "713-392-6561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3845 PHELAN BLVD",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072243",
"telephone_number": "409-833-4437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MELVIN",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-15",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "55667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.