Healthcare Provider Details

I. General information

NPI: 1235689092
Provider Name (Legal Business Name): DEEPA PATTANI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date: 09/24/2018
Reactivation Date: 01/18/2019

III. Provider practice location address

1144 N PLANO RD STE 129
RICHARDSON TX
75081-2454
US

IV. Provider business mailing address

1144 N PLANO RD STE 129
RICHARDSON TX
75081-2454
US

V. Phone/Fax

Practice location:
  • Phone: 972-372-9775
  • Fax:
Mailing address:
  • Phone: 972-372-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57533
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: