Provider Demographics
NPI:1245678283
Name:NAGARSHETH, KUNAL (PHARMD)
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:
Last Name:NAGARSHETH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 WILLIAMS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3261
Mailing Address - Country:US
Mailing Address - Phone:512-820-0101
Mailing Address - Fax:512-820-1244
Practice Address - Street 1:2411 WILLIAMS DR STE 3
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-820-0101
Practice Address - Fax:512-820-1244
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45853OtherTSBP LICENSE