MEDICARE: ANITHA GNALIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	49833	TX
2	183500000X	Pharmacist	52376	NY

General Provider Information

NPI Number	:	1083951891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITHA GNALIAN

Provider Business Mailing Address
First Line	:	5600 BABCOCK RD
Second Line	:	# 14102
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1811
Country	:	US
Telephone Number	:	347-255-6323
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 BABCOCK RD
Second Line	:	# 14102
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1811
Country	:	US
Telephone Number	:	347-255-6323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	01/14/2013

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Directions to “ ANITHA GNALIAN ” Practice Location

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