Provider Demographics
NPI:1629669288
Name:PUNDIR, ADESH
Entity Type:Individual
Prefix:
First Name:ADESH
Middle Name:
Last Name:PUNDIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 HIGH LANDING DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6040
Mailing Address - Country:US
Mailing Address - Phone:214-755-7525
Mailing Address - Fax:
Practice Address - Street 1:3005 E RENNER RD STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3570
Practice Address - Country:US
Practice Address - Phone:214-324-5100
Practice Address - Fax:214-324-5102
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist