Prashnanth Burguru
Individual provider Active NPI Pharmacist · Odessa, TX
NPI 1275176554 · NPPES record last updated Oct 19, 2019
Key facts
- NPI
- 1275176554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 48488 (TX)
- Practice address
- 7 Glass Ranch Rd
Odessa, TX 79765-2259 - Phone
- (432) 381-6658
- NPI assigned
- Oct 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48488 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 48488 | TX | Yes |
Addresses
Primary practice location
7 Glass Ranch Rd
Odessa, TX 79765-2259
Mailing address
7 Glass Ranch Rd
Odessa, TX 79765-2259
Phone (432) 381-6658
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10157733 | Other | TX | DPS |
| 48488 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.