Provider Demographics
NPI:1346008547
Name:THOTA, KRISHNAPRIYA
Entity Type:Individual
Prefix:
First Name:KRISHNAPRIYA
Middle Name:
Last Name:THOTA
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 1:5350 INDEPENDENCE PKWY # 110A
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4652
Mailing Address - Country:US
Mailing Address - Phone:469-885-9100
Mailing Address - Fax:
Practice Address - Street 1:5350 INDEPENDENCE PKWY # 110A
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4652
Practice Address - Country:US
Practice Address - Phone:469-885-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist