Individual provider Active NPI

Prathusha Grace Bethala

  • Pharmacist
  • The Woodlands, TX
National Provider Identifier
1902621469
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
74998 Issued in TX
Practice address
8000 Research Forest Dr Ste 100
The Woodlands, TX 77382-1506
Phone
(281) 292-3861
NPI assigned
Nov 20, 2024
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 74998 TX Primary

Addresses

Primary practice location

8000 Research Forest Dr Ste 100
The Woodlands, TX 77382-1506

Mailing address

17915 Camp Cove Dr
Cypress, TX 77429-7657
Phone (203) 503-1518

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
74998TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Nov 24, 2024 Accepting new patients
Walgreen Co PastSince Nov 24, 2024 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": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1902621469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17915 CAMP COVE DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774297657",
            "telephone_number": "203-503-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 RESEARCH FOREST DR STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773821506",
            "telephone_number": "281-292-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHALA",
        "first_name": "PRATHUSHA",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "74998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.