MEDICARE: VRAJESH RAJESH KANCHANWALA

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	73663	TX

General Provider Information

NPI Number	:	1881459394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VRAJESH RAJESH KANCHANWALA

Provider Business Mailing Address
First Line	:	6600 PLUM CREEK DR APT 254
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79124-1632
Country	:	US
Telephone Number	:	171-349-9970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2931 CENTRAL CITY BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-1129
Country	:	US
Telephone Number	:	409-740-2488
Fax Number	:	409-740-8320

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

Provider Enumeration Date	:	02/14/2024
Last Update Date	:	02/09/2025

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