Organization
KALI NAGABALAJI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KISHORE SINGIRIKONDA (MANAGING OFFICER)
(269) 903-9772
Entity
Organization
Contact information
Practice address
200 W J BOAZ RD, STE 100, SAGINAW, TX 76179
(817) 405-3333
(817) 405-3341
Mailing address
200 W J BOAZ RD, STE 100, SAGINAW, TX 76179
(817) 405-3333
(817) 405-3341
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29537
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
09/29/2014
Last updated
10/01/2014
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