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NPI Code Detail

MEDICARE: MONA PATEL PETIGARA RPH

MEDICARE: MONA PATEL PETIGARA RPH
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
1183500000XPharmacist61527TX

General Provider Information

NPI Number : 1740885763
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA PATEL PETIGARA RPH
Provider Business Mailing Address
First Line : 1513 S VALLEY MILLS DR
Second Line :
City : BEVERLY HILLS
State : TX
Zip : 76711-1683
Country : US
Telephone Number : 254-756-1876
Fax Number :
Provider Business Practice Location Address
First Line : 1513 S VALLEY MILLS DR
Second Line :
City : BEVERLY HILLS
State : TX
Zip : 76711-1683
Country : US
Telephone Number : 254-756-1876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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