Provider Demographics
NPI:1275210940
Name:MEHTA, KANDARP C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KANDARP
Middle Name:C
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18318 SNORKEL CV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3341
Mailing Address - Country:US
Mailing Address - Phone:251-709-2949
Mailing Address - Fax:
Practice Address - Street 1:18318 SNORKEL CV
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-3341
Practice Address - Country:US
Practice Address - Phone:251-709-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.00244071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist