Active NPI
Jyothi Koduri
- Pharmacist
- Hurst, TX
National Provider Identifier
1740566405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 46673
- Practice address
- 1233 Precinct Line Rd
Hurst, TX 76053-4226 - Phone
- (817) 595-2484
- NPI assigned
- Oct 26, 2011
- Last updated
- Nov 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 46673 | TX | Primary |
Addresses
Primary practice location
1233 Precinct Line Rd
Hurst, TX 76053-4226
Mailing address
Appikatla Village
Guntur District. Andhra Prudish Statr
Appikatla, BAPATLA 50001
IN
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46673 | Other | TX | PHARMACIST LICENSE TEXAS |
Other names 1
- Mrs. Jyothi Koduri
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
| License | State | Type | Specialty |
|---|---|---|---|
| 46673 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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": "1319587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606521600000",
"number": "1740566405",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "APPIKATLA VILLAGE",
"address_2": "GUNTUR DISTRICT. ANDHRA PRUDISH STATR",
"city": "APPIKATLA",
"state": "BAPATLA",
"postal_code": "50001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 PRECINCT LINE RD",
"city": "HURST",
"state": "TX",
"postal_code": "760534226",
"telephone_number": "817-595-2484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODURI",
"first_name": "JYOTHI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-26",
"last_updated": "2020-11-28",
"certification_date": "2020-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "46673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE TEXAS",
"identifier": "46673",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JYOTHI",
"last_name": "KODURI",
"prefix": "MRS.",
"credential": "RPH",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Hurst, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.