Individual
DR. CHAITANYA KODURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
2051 HALL JOHNSON RD, GRAPEVINE, TX 76051-8735
(817) 410-8808
Mailing address
2051 HALL JOHNSON RD, GRAPEVINE, TX 76051-8735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
49571
TX
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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