Provider Demographics
NPI:1336764265
Name:CHUNDURI, MADHURI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MADHURI
Middle Name:
Last Name:CHUNDURI
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 1:1505 S HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-7807
Mailing Address - Country:US
Mailing Address - Phone:409-853-4100
Mailing Address - Fax:409-853-4200
Practice Address - Street 1:1505 S HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-7807
Practice Address - Country:US
Practice Address - Phone:409-853-4100
Practice Address - Fax:409-853-4200
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist