Provider Demographics
NPI:1972291722
Name:CHIGURUPATI, MANASWI
Entity type:Individual
Prefix:
First Name:MANASWI
Middle Name:
Last Name:CHIGURUPATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 BABCOCK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4467
Mailing Address - Country:US
Mailing Address - Phone:210-467-5174
Mailing Address - Fax:210-467-5184
Practice Address - Street 1:2026 BABCOCK RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4467
Practice Address - Country:US
Practice Address - Phone:210-467-5174
Practice Address - Fax:210-467-5184
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60054183500000X
TX71482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist