Kelechi Victor Etoh, PHARMD, MPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

70790 Issued in TX

Practice address

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Phone

(469) 614-4905

NPI assigned

Aug 8, 2022

Last updated

Aug 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1932837028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 STONELEDGE DR APT 1434",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "469-614-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4209 Creek Falls Dr",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "TX",
            "postal_code": "762085187",
            "country_code": "US",
            "telephone_number": "469-614-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETOH",
        "first_name": "KELECHI",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "PHARMD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "70790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "4696144905",
            "affiliation": "N",
            "address_1": "2600 Saint Michael Dr",
            "city": "Texarkana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "755032372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Encompass Health Rehabilitation Hospital of Texarkana, Inc. (Encompass Health Rehabilitation Hospital of Texarkana)
• Marla Kay English-Pickett, GNP
• George William English III, M.D.
• Gary P Engstrom, MD
• Kouaba Marie Elodie Carmen Enoh
• Margaret E. Evans, P.T.
• Evergreen Presbyterian Ministries of Texas, Inc. (Evergreen Danville Road Community Home)
• Evergreen Presbyterian Ministries of Texas, Inc. (Evergreen HCS NETX 1)
• Evergreen Presbyterian Ministries of Texas, Inc. (Evergreen Cooper Lane Community Home)
• Evergreen Presbyterian Ministries of Texas, Inc. (Evergreen Life Services)

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.