Provider Demographics
NPI:1720676331
Name:JUNNARKAR, VAIDEHI
Entity Type:Individual
Prefix:
First Name:VAIDEHI
Middle Name:
Last Name:JUNNARKAR
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 1:14006 STEELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5775
Mailing Address - Country:US
Mailing Address - Phone:281-235-5184
Mailing Address - Fax:
Practice Address - Street 1:322 CANE ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7982
Practice Address - Country:US
Practice Address - Phone:346-307-8534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist