Provider Demographics
NPI:1750737334
Name:CHAUDHARI, GAURAVKUMAR HEMRAJBHAI (PHARMD)
Entity type:Individual
Prefix:
First Name:GAURAVKUMAR
Middle Name:HEMRAJBHAI
Last Name:CHAUDHARI
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 1:11210 SEAN HAGGERTY DR
Mailing Address - Street 2:APT 17201
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3443
Mailing Address - Country:US
Mailing Address - Phone:917-476-5281
Mailing Address - Fax:
Practice Address - Street 1:550 E LISA DR STE C
Practice Address - Street 2:
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-8080
Practice Address - Country:US
Practice Address - Phone:575-824-5242
Practice Address - Fax:575-824-4066
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2019-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55447183500000X
NMRP8490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist