NPIMap

Individual provider Active NPI

Inoussa Tairou, PHARMD

  • Pharmacist
  • Marshall, TX
National Provider Identifier
1922603612
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63736 Issued in TX
Practice address
400 E End Blvd N # 4
Marshall, TX 75670-3608
Phone
(903) 935-6661
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 63736 TX
Pharmacist 183500000X 63736 TX Primary

Addresses

Primary practice location

400 E End Blvd N # 4
Marshall, TX 75670-3608

Mailing address

400 E End Blvd N
Marshall, TX 75670-3608
Phone (903) 935-6661

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL 9039356661
SOAP URL 9039356661
SOAP URL Marshall

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

LicenseStateTypeSpecialty
63736TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc PastSince Dec 6, 2020 Accepting new patients
CVS Pharmacy Inc PastSince Dec 6, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1922603612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E END BLVD N",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756703608",
            "telephone_number": "903-935-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E END BLVD N # 4",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756703608",
            "telephone_number": "903-935-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIROU",
        "first_name": "INOUSSA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "TX",
            "license": "63736",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "63736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "9039356661",
            "affiliation": "N",
            "address_1": "400 E End Blvd N",
            "city": "Marshall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756703608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "9039356661",
            "affiliation": "N",
            "address_1": "400 E End Blvd N",
            "city": "Marshall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756703608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Marshall",
            "affiliation": "N",
            "address_1": "400 E End Blvd N # 4",
            "city": "Marshall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756703608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.