Smita Balaji Enterprise Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27729 Issued in TX

Legal business name

SMITA BALAJI ENTERPRISE INC

Doing business as

KK's Pharmacy #251

Practice address

980 N Walnut Creek Dr Ste 118
Mansfield, TX 76063-8020

Phone

(817) 453-5700

Fax

(817) 453-5705

NPI assigned

Dec 5, 2011

Last updated

Dec 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kamlesh Kurani

Title

Secretary

Phone

(817) 690-1374

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• KK'S PHARMACY #251 Doing business as

Locations

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1356619365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 N WALNUT CREEK DR STE 118",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638020",
            "telephone_number": "817-453-5700",
            "fax_number": "817-453-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 N WALNUT CREEK DR STE 118",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638020",
            "telephone_number": "817-453-5700",
            "fax_number": "817-453-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITA BALAJI ENTERPRISE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "KURANI",
        "authorized_official_first_name": "KAMLESH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "817-690-1374"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27729",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146499",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132931",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KK'S PHARMACY #251",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Barbara Smith-Jordan, LPC, LCDC
• Alexa Smith, NP
• James Smith, DPT
• Kelsey Smith, DC
• Laura A Smith, APRN, PMHNP-BC

• Community/Retail Pharmacy in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.