Provider Demographics
NPI:1285971622
Name:SHRI BALAJI DRUGS INC
Entity type:Organization
Organization Name:SHRI BALAJI DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VENKATA KIRAN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-314-6782
Mailing Address - Street 1:8832 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240
Mailing Address - Country:US
Mailing Address - Phone:210-314-6782
Mailing Address - Fax:210-314-6820
Practice Address - Street 1:8832 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-314-6782
Practice Address - Fax:210-314-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-04
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149902Medicaid