Active NPI
Stephen Edward Wyatt, PHARMD, RPH
- Pharmacist
- Nacogdoches, TX
National Provider Identifier
1881863868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45189
- Practice address
- 917 E Austin St
Nacogdoches, TX 75965-2845 - Phone
- (936) 564-7373
- Fax
- (936) 564-9338
- NPI assigned
- Feb 25, 2008
- 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 | 183500000X | 45189 | TX | Primary |
Addresses
Primary practice location
917 E Austin St
Nacogdoches, TX 75965-2845
Mailing address
917 E Austin St
Nacogdoches, TX 75965-2845
Phone (936) 564-7373
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 |
|---|---|---|---|
| 45189 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M & S Pharmacy, Inc. | Past | Accepting new patients | |
| M & S Pharmacy, Inc. | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Nacogdoches, TX
- NPI 1679642250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1881863868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 E AUSTIN ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759652845",
"telephone_number": "936-564-7373",
"fax_number": "936-564-9338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 E AUSTIN ST",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759652845",
"telephone_number": "936-564-7373",
"fax_number": "936-564-9338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "STEPHEN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-25",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "45189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.