MEDICARE: DINESH SRIPERAMBUDUR

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	44831	TX

General Provider Information

NPI Number	:	1467609628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINESH SRIPERAMBUDUR

Provider Business Mailing Address
First Line	:	1733 TEXOMA PKWY STE 200
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-2613
Country	:	US
Telephone Number	:	603-540-9492
Fax Number	:	903-893-1702

Provider Business Practice Location Address
First Line	:	1733 TEXOMA PKWY STE 200
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-2613
Country	:	US
Telephone Number	:	903-893-1700
Fax Number	:	903-893-1702

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

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	11/20/2020

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Directions to “ DINESH SRIPERAMBUDUR ” Practice Location

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