Pharrmacy – Clinic/Center, NPI 1396816518
Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Pharrmacy
900 W SAM HOUSTON BLVD STE 3
PHARR, TX 785775215
Phone: (956) 283-0911
Fax: (956) 283-1884
Type: Mailing
1002, West Sam Houston Boulevard, McDaniel Colonia, Pharr, Hidalgo County, Texas, 78577, United States
SUITE 1
PHARR, TX 78577
Phone: (956) 283-0911
Fax: (956) 283-1884
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-10-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (253 days ago).
Enrollment records
3
Earliest due date
2025-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200811000701 | O | Pharmacy | TX | 2026-01-31 |
| O20201001001531 | O | Pharmacy | TX | 2025-09-30 |
| O20211004002702 | O | Independent Clinical Laboratory | TX | 2026-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 78577)
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