Provider Demographics
NPI:1689974024
Name:PILLI, MALINI S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MALINI
Middle Name:S
Last Name:PILLI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 TAOS TRL
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-5636
Mailing Address - Country:US
Mailing Address - Phone:281-930-1968
Mailing Address - Fax:
Practice Address - Street 1:3920 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3106
Practice Address - Country:US
Practice Address - Phone:281-420-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist