Provider Demographics
NPI:1437279684
Name:DALAL, KAVITA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KAVITA
Middle Name:
Last Name:DALAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST STOP 8162
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8162
Mailing Address - Country:US
Mailing Address - Phone:806-743-4200
Mailing Address - Fax:806-743-4209
Practice Address - Street 1:3601 4TH ST STOP 8162
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8162
Practice Address - Country:US
Practice Address - Phone:806-743-4200
Practice Address - Fax:806-743-4209
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40769183500000X
FLPS 39766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist