Provider Demographics
NPI:1528379682
Name:ANTANI, MEGHANA KAVIT
Entity Type:Individual
Prefix:MRS
First Name:MEGHANA
Middle Name:KAVIT
Last Name:ANTANI
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 1:2507 NORMA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-3554
Mailing Address - Country:US
Mailing Address - Phone:410-274-6152
Mailing Address - Fax:
Practice Address - Street 1:701 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1553
Practice Address - Country:US
Practice Address - Phone:956-683-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist