Provider Demographics
NPI:1013482041
Name:PANDIT, UMANGI
Entity Type:Individual
Prefix:
First Name:UMANGI
Middle Name:
Last Name:PANDIT
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 1:120 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-5014
Mailing Address - Country:US
Mailing Address - Phone:940-648-2222
Mailing Address - Fax:
Practice Address - Street 1:120 W 4TH ST
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-5014
Practice Address - Country:US
Practice Address - Phone:201-310-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist