Healthcare Provider Details

I. General information

NPI: 1841109659
Provider Name (Legal Business Name): PETER KANYIRI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 W PARKER RD
PLANO TX
75093-8185
US

IV. Provider business mailing address

4315 MIMOSA DR
MELISSA TX
75454-0250
US

V. Phone/Fax

Practice location:
  • Phone: 469-734-0978
  • Fax:
Mailing address:
  • Phone: 469-734-0978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53640
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: