Active NPI
Owoedimo Benedict Usoro, PHARMD
- Pharmacist
- Irving, TX
National Provider Identifier
1891397873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46880
- Practice address
- 1635 Market PL
Irving, TX 75063-7239 - Phone
- (214) 574-4522
- NPI assigned
- Nov 13, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 054413 | NY | |
| Pharmacist | 183500000X | 28RI03241200 | NJ | |
| Pharmacist | 183500000X | 46880 | TX | Primary |
Addresses
Primary practice location
1635 Market PL
Irving, TX 75063-7239
Mailing address
202 Turnberry LN
Coppell, TX 75019-2066
Phone (201) 707-0946
Other practice location 1
202 Turnberry Ln
Coppell, TX 75019-2066
Phone (201) 707-0946
Other practice location 2
3901 W 15th St
Plano, TX 75075-7738
Phone (972) 519-1181
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03241200 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1891397873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 TURNBERRY LN",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192066",
"telephone_number": "201-707-0946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 MARKET PL",
"city": "IRVING",
"state": "TX",
"postal_code": "750637239",
"telephone_number": "214-574-4522"
}
],
"practiceLocations": [
{
"address_1": "202 Turnberry Ln",
"address_purpose": "LOCATION",
"city": "Coppell",
"state": "TX",
"postal_code": "750192066",
"country_code": "US",
"telephone_number": "201-707-0946",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3901 W 15th St",
"address_purpose": "LOCATION",
"city": "Plano",
"state": "TX",
"postal_code": "750757738",
"country_code": "US",
"telephone_number": "972-519-1181",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "USORO",
"first_name": "OWOEDIMO",
"middle_name": "BENEDICT",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-13",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "054413",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03241200",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "46880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.