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Dr. Wilson Lee Krezdorn , PharmD

Pharmacist β€’ Tyler, TX

Active NPI 1144557448 Individual Practitioner Male Practitioner
Practice location in NPPES

2130 W Grande Blvd
Tyler, TX 757030563

Call 9037072034 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2130 W Grande Blvd

Tyler, TX 757030563

Telephone 9037072034
Fax 9037072036
Organization at the Same NPPES Address or Phone
Rose City Pharmacy Llc Facility NPI 1780101816

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Tyler, TX. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2009

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Tyler and Texas

180 active clinicians are listed under Pharmacist with a practice address in Tyler, TX (18,560 in Texas).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Tyler

0% of these 180 clinicians have the CMS telehealth indicator.

0% of these 180 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-04-16
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

License # reported to NPPES TX 45300

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Secondary Practice Locations

5976 Old Jacksonville Hwy

Tyler, TX 75703

Phone: 9034056215

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
βœ…
NPI Profile Active August 29, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location August 29, 2017

Registered at 2130 W GRANDE BLVD, TYLER, TX 757030563 (Tel: 9037072034)

πŸ“
Updated Business Mailing Address August 29, 2017

Registered at 18248 SPRINGMILL CT, FLINT, TX 757625000 (Tel: (903) 952-1698)

πŸ‘€
Provider Name / Credentials Updated August 29, 2017

Recorded as WILSON KREZDORN, PHARM.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2017

Pharmacist (license number reported to NPPES: TX 45300)

βœ…
NPI Profile Active December 29, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 29, 2015

Registered at 5976 OLD JACKSONVILLE HWY, TYLER, TX 75703 (Tel: 9034056215)

πŸ“
Business Mailing Address (Initial Record) December 29, 2015

Registered at 18248 SPRINGMILL CT, FLINT, TX 757625000 (Tel: 9039521698)

πŸ‘€
Provider Name / Credentials (Initial Record) December 29, 2015

Recorded as WILSON KREZDORN, PHARM.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 29, 2015

Pharmacist (license number reported to NPPES: TX 45300)

🟒
Initial NPI Registration & Enumeration November 06, 2009

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1144557448
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 06, 2009
Last Update: July 21, 2022
Sole Proprietor: No

Other Pharmacists in Tyler

All Pharmacists in Tyler

Mailing Address

18248 Springmill Ct

Flint, TX 757625000

Phone: 9039521698

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.