Active NPI
John Wayne Mathews, RPH
- Pharmacist
- Henrietta, TX
National Provider Identifier
1841890936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30165
- Practice address
- 124 N Bridge St
Henrietta, TX 76365-2804 - Phone
- (940) 538-4361
- NPI assigned
- Oct 28, 2020
- Last updated
- Oct 28, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 30165 | TX | Primary |
Addresses
Primary practice location
124 N Bridge St
Henrietta, TX 76365-2804
Mailing address
124 N Bridge St
Henrietta, TX 76365-2804
Phone (940) 538-4361
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 |
|---|---|---|---|
| 30165 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henrietta Pharmacy, Inc. | Current | Accepting new patients | |
| Henrietta Pharmacy Inc | Past | Accepting new patients |
Locations
124 N Bridge St
Henrietta, TX 76365
Phone (940) 538-4361
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.
-
- Long Term Care Pharmacy
- Henrietta, TX
- NPI 1790524296
-
- Community/Retail Pharmacy
- Henrietta, TX
- NPI 1770633703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1841890936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 N BRIDGE ST",
"city": "HENRIETTA",
"state": "TX",
"postal_code": "763652804",
"telephone_number": "940-538-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 N BRIDGE ST",
"city": "HENRIETTA",
"state": "TX",
"postal_code": "763652804",
"telephone_number": "940-538-4361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "JOHN",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "30165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henrietta, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.