Active NPI
Raja Avanadula
- Pharmacist
- Bonham, TX
National Provider Identifier
1902189665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 013223
- Practice address
- 2108 N Center St
Bonham, TX 75418-2628 - Phone
- (903) 583-8017
- NPI assigned
- Sep 20, 2011
- Last updated
- May 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 51172 | TX | |
| Pharmacist | 183500000X | 013223 | KY | Primary |
Addresses
Primary practice location
2108 N Center St
Bonham, TX 75418-2628
Mailing address
2108 N Center St
Bonham, TX 75418-2628
Phone (903) 583-8017
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 |
|---|---|---|---|
| 013223 | KY | MD | Pharmacist |
| 51172 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sai Drugs Inc | Current | Accepting new patients | |
| Sai Drugs Inc | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2108 N Center St
Bonham, TX 75418
Phone (903) 583-8017
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": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588723200000",
"number": "1902189665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 N CENTER ST",
"city": "BONHAM",
"state": "TX",
"postal_code": "754182628",
"telephone_number": "903-583-8017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 N CENTER ST",
"city": "BONHAM",
"state": "TX",
"postal_code": "754182628",
"telephone_number": "903-583-8017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVANADULA",
"first_name": "RAJA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2020-05-06",
"certification_date": "2020-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "51172",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "013223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonham, TX
- Armstrong, Draughn & Cooper, LTD. (The Woodmoore)
- John Alan Atchison, MSW
- James Donald Atkins II, L.C.S.W.-
- Attentus Bonham, LP (Red River Regional Hospital)
- Attentus Bonham, LP (Bonham Orthopedic Clinic)
- Deeya Mary Hagen Bain, R.D.
- William Michael Baker, RPH
- Jarrod W Baum
- Dawn Colleen Beeker, RD, RDN
- Phillip Boyd Bellows, D.C. L..AC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.