Provider Demographics
NPI:1790405835
Name:LADANI, KRUTIBEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRUTIBEN
Middle Name:
Last Name:LADANI
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 1:1023 LOBLOLLY PINE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2518
Mailing Address - Country:US
Mailing Address - Phone:817-690-1677
Mailing Address - Fax:
Practice Address - Street 1:4010 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6413
Practice Address - Country:US
Practice Address - Phone:972-650-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist