Active NPI
Constance Roubique
- Pharmacist
- Frisco, TX
National Provider Identifier
1861789323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 41108
- Practice address
- 4268 Legacy Dr
Wal-Mart 5986
Frisco, TX 75034-0812 - Phone
- (972) 624-6002
- NPI assigned
- Jul 6, 2011
- 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 | 41108 | TX | Primary |
Addresses
Primary practice location
4268 Legacy Dr
Wal-Mart 5986
Frisco, TX 75034-0812
Mailing address
4268 Legacy Dr
Wal-Mart 5986
Frisco, TX 75034-0812
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 |
|---|---|---|---|
| 41108 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1861789323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4268 LEGACY DR",
"address_2": "WAL-MART 5986",
"city": "FRISCO",
"state": "TX",
"postal_code": "750340812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4268 LEGACY DR",
"address_2": "WAL-MART 5986",
"city": "FRISCO",
"state": "TX",
"postal_code": "750340812",
"telephone_number": "972-624-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUBIQUE",
"first_name": "CONSTANCE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "41108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.