Individual provider Active NPI

Eric Onyancha Matoke, PHARMACIST

  • Pharmacist
  • Corpus Christi, TX
National Provider Identifier
1902120967
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33391 Issued in TX
Practice address
14041 Northwest Blvd
Ste 2B
Corpus Christi, TX 78410-5137
Phone
(361) 767-1300
Fax
(361) 767-8888
NPI assigned
Mar 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33391 TX Primary

Addresses

Primary practice location

14041 Northwest Blvd
Ste 2B
Corpus Christi, TX 78410-5137

Mailing address

14041 Northwest Blvd
Ste 2B
Corpus Christi, TX 78410-5137
Phone (361) 767-1300

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

LicenseStateTypeSpecialty
33391TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Matoke Incorporated Southside Pharmacy Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1902120967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14041 NORTHWEST BLVD",
            "address_2": "STE 2B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784105137",
            "telephone_number": "361-767-1300",
            "fax_number": "361-767-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14041 NORTHWEST BLVD",
            "address_2": "STE 2B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784105137",
            "telephone_number": "361-767-1300",
            "fax_number": "361-767-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOKE",
        "first_name": "ERIC",
        "middle_name": "ONYANCHA",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "33391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.