Organization
SMITA BALAJI ENTERPRISE INC
Active
Other names
KK'S PHARMACY #251
Organization subpart
No
Provider details
NPI number
Authorized official
KAMLESH KURANI (SECRETARY)
(817) 690-1374
Entity
Organization
Contact information
Practice address
980 N WALNUT CREEK DR STE 118, MANSFIELD, TX 76063-8020
(817) 453-5700
(817) 453-5705
Mailing address
980 N WALNUT CREEK DR STE 118, MANSFIELD, TX 76063-8020
(817) 453-5700
(817) 453-5705
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27729
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146499
—
TX
01
—
2132931
PK
—
Enumeration date
12/05/2011
Last updated
12/31/2014
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