Active NPI
Tyrrell Dashawn Moore, PHARMD
- Pharmacist
- Cedar Hill, TX
National Provider Identifier
1922611763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63360
- Practice address
- 501 E Belt Line Rd
Cedar Hill, TX 75104-2210 - Phone
- (972) 291-2787
- NPI assigned
- Aug 30, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63360 | TX | Primary |
Addresses
Primary practice location
501 E Belt Line Rd
Cedar Hill, TX 75104-2210
Mailing address
254 N State Highway 360 Apt 12302
Mansfield, TX 76063-3134
Phone (972) 955-6234
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rxm.05210@walgreens.store.com | Direct |
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 |
|---|---|---|---|
| 63360 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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.
-
- Pharmacy
- Longview, TX
- NPI 1629956545
-
- Pharmacy
- Cedar Hill, TX
- NPI 1851306823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598745600000",
"number": "1922611763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 N STATE HIGHWAY 360 APT 12302",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633134",
"telephone_number": "972-955-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E BELT LINE RD",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751042210",
"telephone_number": "972-291-2787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "TYRRELL",
"middle_name": "DASHAWN",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-30",
"last_updated": "2020-08-30",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "63360",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rxm.05210@walgreens.store.com",
"affiliation": "N",
"endpointDescription": "Company email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "501 E Belt Line Rd",
"city": "Cedar Hill",
"state": "TX",
"country_code": "US",
"postal_code": "751042210",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cedar Hill, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.