Nicholas B Hogue, PHARM D
Individual provider Active NPI Pharmacist · Canutillo, TX
NPI 1962824235 · NPPES record last updated Jan 6, 2014
Key facts
- NPI
- 1962824235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 43416 (TX)
- Practice address
- 521 Phil Hansen Dr
Canutillo, TX 79835-8311 - Phone
- (915) 252-2503
- NPI assigned
- Jan 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S018053 | AZ | MD | Pharmacist |
| 43416 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43416 | TX | Yes |
| Pharmacist | 183500000X | S018053 | AZ |
Addresses
Primary practice location
521 Phil Hansen Dr
Canutillo, TX 79835-8311
Mailing address
521 Phil Hansen Dr
Canutillo, TX 79835-8311
Phone (915) 252-2503
Other providers in Canutillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.