Gollapudi Siva Shankar, MS, PHARMD, PHC, BCP

Primary specialty

Psychiatric PharmacistTaxonomy code 1835P1300X

License

40595 Issued in CA

Practice address

4602 N Bartlett Ave
Laredo, TX 78041-3803

Phone

(956) 523-7850

Fax

(956) 523-7851

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Doctor of Pharmacy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1174528046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 N BARTLETT AVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780453803",
            "telephone_number": "956-523-7850",
            "fax_number": "956-523-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 N BARTLETT AVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780413803",
            "telephone_number": "956-523-7850",
            "fax_number": "956-523-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKAR",
        "first_name": "GOLLAPUDI",
        "middle_name": "SIVA",
        "name_prefix": "Dr.",
        "credential": "MS, PHARMD, PHC, BCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CA",
            "license": "40595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Pharmacist in Laredo, TX
• Providers in Laredo, TX by specialty
• Psychiatric Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.