Healthcare Provider Details

I. General information

NPI: 1265996813
Provider Name (Legal Business Name): DR. SATYA KIRAN VEMPATI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2906 HILLRISE DR
LAS CRUCES NM
88011-4702
US

IV. Provider business mailing address

2775 N ROADRUNNER PKWY APT 5602
LAS CRUCES NM
88011-8150
US

V. Phone/Fax

Practice location:
  • Phone: 732-456-0027
  • Fax: 575-323-3036
Mailing address:
  • Phone: 732-456-0027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00009029
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: