Individual provider Active NPI

Marsha Proctor, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, TX
National Provider Identifier
1942569462
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
31460 Issued in TX
Practice address
4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone
(800) 849-3597
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31460 TX
Geriatric Pharmacist 1835G0303X 31460 TX
Nutrition Support Pharmacist 1835N1003X 31460 TX
Oncology Pharmacist 1835X0200X 31460 TX
Ambulatory Care Pharmacist 1835P2201X 31460 TX
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 31460 TX Primary

Addresses

Primary practice location

4500 S Lancaster Rd
Dallas, TX 75216-7167

Mailing address

8111 Oak Hollow Dr
Arlington, TX 76001-7250

Other practice location 1

1724 E Broad St Ste 136
Mansfield, TX 76063-9140
Phone (817) 453-5022

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
31460TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Medtex Infusion Therapy LLC Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist Current Accepting new patients
Infusion Services & Specialty Pharmacy Current Accepting new patients

Locations

1724 E Broad St
Ste 136
Mansfield, TX 76063
Phone (817) 453-5022

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": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1942569462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 OAK HOLLOW DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760017250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "800-849-3597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 E Broad St Ste 136",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760639140",
            "country_code": "US",
            "telephone_number": "817-453-5022",
            "fax_number": "817-453-5027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "MARSHA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "31460",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "TX",
            "license": "31460",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "TX",
            "license": "31460",
            "primary": false
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "TX",
            "license": "31460",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "TX",
            "license": "31460",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "31460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.