Active NPI
Gangadhar Revuluri, PHARMACIST
- Pharmacist
- San Antonio, TX
National Provider Identifier
1174755995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20196
- Practice address
- 2829 Babcock Rd Ste 120
San Antonio, TX 78229-6009 - Phone
- (210) 617-4311
- Fax
- (210) 617-4312
- NPI assigned
- Aug 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20196 | NC | Primary |
Addresses
Primary practice location
2829 Babcock Rd Ste 120
San Antonio, TX 78229-6009
Mailing address
60-15,Gandhi Bazaar
Rayachoty, ANDHRA PRADESH 516269
IN
Phone (944) 025-6701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20196 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun Pharma LLC | Current | Accepting new patients |
Locations
2829 Babcock Rd
Ste 120
San Antonio, TX 78229
Phone (210) 617-4311
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- San Antonio, TX
- NPI 1629462932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1174755995",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "60-15,GANDHI BAZAAR",
"city": "RAYACHOTY",
"state": "ANDHRA PRADESH",
"postal_code": "516269",
"telephone_number": "944-025-6701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2829 BABCOCK RD STE 120",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782296009",
"telephone_number": "210-617-4311",
"fax_number": "210-617-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVULURI",
"first_name": "GANGADHAR",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-12",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "20196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.