Active NPI
Otis Bandy Jr.
- Pharmacist
- Weatherford, TX
National Provider Identifier
1912370941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22108
- Practice address
- 317 South Main Street
Weatherford, TX 76086 - Phone
- (817) 594-5771
- NPI assigned
- Nov 13, 2015
- 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 | 22108 | TX | Primary |
Addresses
Primary practice location
317 South Main Street
Weatherford, TX 76086
Mailing address
300 North Highway 171
Godley, TX 76044-0095
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 |
|---|---|---|---|
| 22108 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447372800000",
"number": "1912370941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 NORTH HIGHWAY 171",
"city": "GODLEY",
"state": "TX",
"postal_code": "760440095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 SOUTH MAIN STREET",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "76086",
"telephone_number": "817-594-5771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDY",
"first_name": "OTIS",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-13",
"last_updated": "2015-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "22108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.