Healthcare Provider Details

I. General information

NPI: 1366277600
Provider Name (Legal Business Name): ASHA MOPARTHI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 FANNIN ST
HOUSTON TX
77054-1938
US

IV. Provider business mailing address

5715 JENOLAN RIDGE LN
SUGAR LAND TX
77479-4767
US

V. Phone/Fax

Practice location:
  • Phone: 844-855-0101
  • Fax:
Mailing address:
  • Phone: 512-983-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: