Active NPI
Eric Ellison Sr., PHARMD
- Pharmacist
- Houston, TX
National Provider Identifier
1932517521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 53369
- Practice address
- 6402 Lyons
Houston, TX 77020-4917 - Phone
- (713) 674-6916
- Fax
- (713) 674-3297
- NPI assigned
- Jul 26, 2014
- Last updated
- Aug 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 53369 | TX | Primary |
Addresses
Primary practice location
6402 Lyons
Houston, TX 77020-4917
Mailing address
6402 Lyons Ave
Houston, TX 77020-4917
Phone (713) 674-6916
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932517521 | Medicaid | TX |
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 |
|---|---|---|---|
| 53369 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kashmere Pharmacy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Houston, TX
- NPI 1346234549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471651200000",
"number": "1932517521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6402 LYONS AVE",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770204917",
"telephone_number": "713-674-6916",
"fax_number": "713-673-3297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6402 LYONS",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770204917",
"telephone_number": "713-674-6916",
"fax_number": "713-674-3297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "ERIC",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-26",
"last_updated": "2016-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "53369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932517521",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.