Provider Demographics
NPI:1376862201
Name:KAZA, SIVA RAMA KRISHNA (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:SIVA RAMA KRISHNA
Middle Name:
Last Name:KAZA
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18979 REDLAND RD
Mailing Address - Street 2:APT # 2202
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3688
Mailing Address - Country:US
Mailing Address - Phone:210-957-2523
Mailing Address - Fax:
Practice Address - Street 1:6017 INGRAM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-4403
Practice Address - Country:US
Practice Address - Phone:210-957-2523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist