Provider Demographics
NPI:1740390723
Name:KRISHNAMURTHY, KALPANA S
Entity Type:Individual
Prefix:MRS
First Name:KALPANA
Middle Name:S
Last Name:KRISHNAMURTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KALPANA
Other - Middle Name:S
Other - Last Name:KRISHNAMURTHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:B S PHARMACY
Mailing Address - Street 1:255 KAILEY WAY
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2114
Mailing Address - Country:US
Mailing Address - Phone:872-304-0844
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-0582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist