Provider Demographics
NPI:1457956310
Name:CHACKACHERRY, ANU ANYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANU
Middle Name:ANYAN
Last Name:CHACKACHERRY
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 1:13417 RAVENS PARK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4061
Mailing Address - Country:US
Mailing Address - Phone:832-713-2076
Mailing Address - Fax:
Practice Address - Street 1:4010 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3071
Practice Address - Country:US
Practice Address - Phone:281-998-2303
Practice Address - Fax:281-998-2318
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX50405OtherTEXAS STATE BOARD OF PHARMACY