Kullasub Tanased, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

63397 Issued in TX

Practice address

6420 Gaston Ave
Dallas, TX 75214-4022

Phone

(469) 334-0758

NPI assigned

Aug 17, 2020

Sex

Female

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

Doctor of Pharmacy

State licenses

Practice roles

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.

• CVS Pharmacy Inc

  • Pharmacy
  • Stafford, TX
  • NPI 1427931351
  NPD (past)
• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1538575469
  NPD (past)

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1467064949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752144022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752144022",
            "telephone_number": "469-334-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANASED",
        "first_name": "KULLASUB",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "63397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommy Tan
• Wei-Han Tan, M.D.
• Weiyi Tan, M.D, M.P.H.
• Tanaka Transport
• Kelly Ann Tanase, PA-C
• Isabel Natasha Tanco, LPC, NCC, RAS
• Stephanie Bliss Tancred, ENP
• Jenna Grace Tancredi
• Anumeha Tandon, M.D.
• Aanchal Taneja, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.