Active NPI
Brillyone Nicole Fontenot
- Pharmacist
- Temple, TX
National Provider Identifier
1861768707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51056
- Practice address
- 1901 Veterans Memorial Dr
Temple, TX 76504-7451 - Phone
- (254) 743-0876
- NPI assigned
- Mar 26, 2012
- Last updated
- Mar 26, 2012
- Sex
- Female
- 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 | 51056 | TX | Primary |
Addresses
Primary practice location
1901 Veterans Memorial Dr
Temple, TX 76504-7451
Mailing address
11206 Edwards Ave
Pearland, TX 77584-5516
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51056 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332720000000",
"number": "1861768707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11206 EDWARDS AVE",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775845516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 VETERANS MEMORIAL DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765047451",
"telephone_number": "254-743-0876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "BRILLYONE",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-26",
"last_updated": "2012-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "51056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.