Provider Demographics
NPI:1174813810
Name:CHINTALAPALLY, RAGHUVEER REDDY (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAGHUVEER
Middle Name:REDDY
Last Name:CHINTALAPALLY
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 1:2716 SW MILITARY DR
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1002
Mailing Address - Country:US
Mailing Address - Phone:210-927-3742
Mailing Address - Fax:210-927-3752
Practice Address - Street 1:2716 SW MILITARY DR
Practice Address - Street 2:STE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1002
Practice Address - Country:US
Practice Address - Phone:210-927-3742
Practice Address - Fax:210-927-3752
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45965OtherTEXAS STATE BOARD OF PHARMACY