Provider Demographics
NPI:1013041854
Name:NAIK, KETAN C (RPH)
Entity Type:Individual
Prefix:MR
First Name:KETAN
Middle Name:C
Last Name:NAIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 OHIO DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2264
Mailing Address - Country:US
Mailing Address - Phone:469-633-0041
Mailing Address - Fax:
Practice Address - Street 1:8621 OHIO DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2264
Practice Address - Country:US
Practice Address - Phone:469-633-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2023-10-26
Deactivation Date:2011-04-18
Deactivation Code:
Reactivation Date:2022-02-21
Provider Licenses
StateLicense IDTaxonomies
TX31258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist