Provider Demographics
NPI:1730782368
Name:ARVISHETTY, SUNIL KUMAR (RPH)
Entity type:Individual
Prefix:
First Name:SUNIL KUMAR
Middle Name:
Last Name:ARVISHETTY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N SAN SABA STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3123
Mailing Address - Country:US
Mailing Address - Phone:210-212-7455
Mailing Address - Fax:210-212-6643
Practice Address - Street 1:315 N SAN SABA STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3123
Practice Address - Country:US
Practice Address - Phone:210-212-7455
Practice Address - Fax:210-212-6643
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist