=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679421200
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MKA HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2026
-----------------------------------------------------
Last Update Date | 03/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1701 GATEWAY BLVD STE 317
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75080-3546
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-505-2423
-----------------------------------------------------
Fax | 844-929-1410
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 GATEWAY BLVD STE 317
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75080-3546
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-505-2423
-----------------------------------------------------
Fax | 844-929-1410
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MADHURI PUTTASWAMY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-695-5940
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------