Basic Information
Provider Information
NPI: 1184115503
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGGARWAL
FirstName: MEERA
MiddleName: VACHHANI
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7909 CHERRY CREEK DR
Address2:  
City: PLANO
State: TX
PostalCode: 750256615
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7400 MERTON MINTER ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294404
CountryCode: US
TelephoneNumber: 2106175300
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/21/2018
LastUpdateDate: 05/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P0018X24166MDY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

No ID Information.


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