Provider Demographics
NPI:1770182057
Name:VEJANDLA, HIMANI (PHD)
Entity Type:Individual
Prefix:MS
First Name:HIMANI
Middle Name:
Last Name:VEJANDLA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 9TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4305
Mailing Address - Country:US
Mailing Address - Phone:940-322-8626
Mailing Address - Fax:940-322-8476
Practice Address - Street 1:1610 9TH ST STE A
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4305
Practice Address - Country:US
Practice Address - Phone:940-322-8626
Practice Address - Fax:940-322-8476
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist