PNV Creative Care, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PNV CREATIVE CARE, INC

Doing business as

Shepherd Pharmacy

Practice address

11011 Highway 150
Shepherd, TX 77371-2839

Phone

(936) 628-2099

Fax

(936) 628-2530

NPI assigned

Apr 2, 2019

Last updated

Oct 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nipul K Patel, RPH

Title

Officer

Phone

(281) 593-3800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shepherd Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1992267785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S WILLIAM BARNETT AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274541",
            "telephone_number": "281-593-3800",
            "fax_number": "281-593-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 HIGHWAY 150",
            "city": "SHEPHERD",
            "state": "TX",
            "postal_code": "773712839",
            "telephone_number": "936-628-2099",
            "fax_number": "936-628-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNV CREATIVE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-02",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "NIPUL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "281-593-3800",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150016",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shepherd Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• LTC Healthcare Shepard Inc (Woodland Park)
• David W. Middlebush
• Stephanie Gail Myers-Kiker
• Laurier Junior Paul, NP
• PNV Creative Care, Inc (Shepherd Pharmacy)
• Gendaraneshy Rodriguez, LVN
• Emily Sheffield
• Shepherd I S D
• Shepherd Isd
• Shepherd Rural Health Clinic PA

• Community/Retail Pharmacy in Shepherd, TX
• Providers in Shepherd, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.