Provider Demographics
NPI:1225700883
Name:GORREPATI, NAVEENA
Entity Type:Individual
Prefix:
First Name:NAVEENA
Middle Name:
Last Name:GORREPATI
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 1:706 E FELT ST
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-3440
Mailing Address - Country:US
Mailing Address - Phone:806-636-8000
Mailing Address - Fax:
Practice Address - Street 1:706 E FELT ST
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-3440
Practice Address - Country:US
Practice Address - Phone:806-636-8000
Practice Address - Fax:806-636-0153
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist