Provider Demographics
NPI:1700218294
Name:SUNDARARAJU, SANGEETHA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:SANGEETHA
Middle Name:
Last Name:SUNDARARAJU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19331 LINCOLN HEIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3810
Mailing Address - Country:US
Mailing Address - Phone:281-630-6089
Mailing Address - Fax:
Practice Address - Street 1:411 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2435
Practice Address - Country:US
Practice Address - Phone:281-579-0910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist