Provider Demographics
NPI:1023603578
Name:VUKOTI, KRISHNA (BS(PHARM), MTECH PHD)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:
Last Name:VUKOTI
Suffix:
Gender:M
Credentials:BS(PHARM), MTECH PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 SHERWOOD WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2910 SHERWOOD WAY STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3516
Practice Address - Country:US
Practice Address - Phone:325-400-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist