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General NPI Number Information
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NPI Number | 1437891165
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Entity Type | Individual
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Provider Name | DAXABEN J KOTHIYA
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 09/28/2024
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Provider Practice Location Address
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Address Line | 4740 W MOCKINGBIRD LN STE 100B
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City | DALLAS
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State | TX
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Zip | 75209-5208
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Country | US
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Telephone | 214-350-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 W MOCKINGBIRD LN STE 100B
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City | DALLAS
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State | TX
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Zip | 75209-5208
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Country | US
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Telephone | 214-350-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69947
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License Number State | TX
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