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General NPI Number Information
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NPI Number | 1124897574
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Entity Type | Organization
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Legal Business Name | JAII GURUDEV FT LLC
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Dates
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Enumeration Date | 12/27/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1023 LIPSCOMB ST STE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-3101
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Country | US
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Telephone | 682-255-0220
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Fax | 682-255-0224
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Provider Business Mailing Address
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Address Line | 2928 PLUMBAGO DR
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City | FORT WORTH
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State | TX
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Zip | 76108-2272
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | BIJAL PATEL
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Credential |
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Telephone | 239-248-9042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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