Sai Krishna Venkata Gangavalli, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

54016 Issued in TX

Practice address

1635 Marketplace Blvd
Irving, TX 75063

Phone

(214) 574-4522

Fax

(214) 574-5068

NPI assigned

Nov 11, 2020

Sex

Male

Sole proprietor

Yes

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

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1467054767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MARKET PL",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750637239",
            "telephone_number": "214-574-4522",
            "fax_number": "214-574-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 MARKETPLACE BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75063",
            "telephone_number": "214-574-4522",
            "fax_number": "214-574-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGAVALLI",
        "first_name": "SAI KRISHNA",
        "middle_name": "VENKATA",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "54016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Gamboa Sejas, MD
• Vicki Gambrell, CPNP
• Mackenzye Gamez
• Brittany Gandy, MD
• Sailaja Ganga
• Alma Gantchev, RN
• Jordan Garcia-Belman
• Adrienne Garcia-O'Malley, LCSW
• Adrian Garcia
• Alex W Garcia, D.P.M.

• Pharmacist in Irving, TX
• Providers in Irving, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.