Provider Demographics
NPI:1811591662
Name:CHAMALA, APARNA
Entity Type:Individual
Prefix:
First Name:APARNA
Middle Name:
Last Name:CHAMALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6510
Mailing Address - Country:US
Mailing Address - Phone:972-459-7725
Mailing Address - Fax:972-459-4673
Practice Address - Street 1:100 W CORPORATE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-6510
Practice Address - Country:US
Practice Address - Phone:972-459-7725
Practice Address - Fax:972-459-4673
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist