Individual provider Active NPI

Jensen Paul Marshall, PHARM. D

  • Pharmacist
  • Conroe, TX
National Provider Identifier
1861797037
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
47614 Issued in TX
Practice address
1200 N Loop 336 W
Conroe, TX 77301-1001
Phone
(936) 760-4116
Fax
(936) 760-4071
NPI assigned
Jan 20, 2011
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 47614 TX Primary

Addresses

Primary practice location

1200 N Loop 336 W
Conroe, TX 77301-1001

Mailing address

1200 N Loop 336 W
Conroe, TX 77301-1001
Phone (936) 760-4116

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1861797037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011001",
            "telephone_number": "936-760-4116",
            "fax_number": "936-760-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011001",
            "telephone_number": "936-760-4116",
            "fax_number": "936-760-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JENSEN",
        "middle_name": "PAUL",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "47614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.