Individual provider Active NPI

Vidya Malladi, PHARMACIST

  • Pharmacist
  • Dallas, TX
National Provider Identifier
1467762955
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52465 Issued in TX
Practice address
5001 Ross Ave
Dallas, TX 75206-7706
Phone
(214) 370-8747
NPI assigned
Oct 18, 2010
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 52465 TX Primary

Addresses

Primary practice location

5001 Ross Ave
Dallas, TX 75206-7706

Mailing address

5001 Ross Ave
Dallas, TX 75206-7706
Phone (214) 370-8747

Other identifiers 1

IdentifierTypeStateIssuer
52465OtherTXTEXAS STATE BOARD OF PHARMACY

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

LicenseStateTypeSpecialty
S014741AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Mar 27, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1467762955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 ROSS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067706",
            "telephone_number": "214-370-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 ROSS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067706",
            "telephone_number": "214-370-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLADI",
        "first_name": "VIDYA",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "52465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "52465",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.