Provider Demographics
NPI:1225365125
Name:BEERAVOLU, RAMANI REDDY
Entity Type:Individual
Prefix:
First Name:RAMANI
Middle Name:REDDY
Last Name:BEERAVOLU
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 1:2360 JUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3071
Mailing Address - Country:US
Mailing Address - Phone:972-966-0526
Mailing Address - Fax:972-966-2114
Practice Address - Street 1:1101 CROSS TIMBERS RD
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1270
Practice Address - Country:US
Practice Address - Phone:972-355-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist