Healthcare Provider Details

I. General information

NPI: 1922400464
Provider Name (Legal Business Name): NIRAL MODI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 WYOMING SPRINGS DR STE 300
ROUND ROCK TX
78681-4311
US

IV. Provider business mailing address

7201 WYOMING SPRINGS DR STE 300
ROUND ROCK TX
78681-4311
US

V. Phone/Fax

Practice location:
  • Phone: 510-456-6080
  • Fax:
Mailing address:
  • Phone: 510-456-6080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55446
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: