Provider Demographics
NPI:1083226385
Name:JANI, GOPI
Entity Type:Individual
Prefix:
First Name:GOPI
Middle Name:
Last Name:JANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6523 PLANETREE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5018
Mailing Address - Country:US
Mailing Address - Phone:281-919-7507
Mailing Address - Fax:
Practice Address - Street 1:6523 PLANETREE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5018
Practice Address - Country:US
Practice Address - Phone:281-919-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX65678OtherTEXAS STATE BOARD OF PHARMACY