Provider Demographics
NPI:1730771486
Name:GAJERA, BIPINKUMAR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:BIPINKUMAR
Middle Name:
Last Name:GAJERA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 BALCONES CLUB DR APT 2113
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2759
Mailing Address - Country:US
Mailing Address - Phone:972-697-3006
Mailing Address - Fax:
Practice Address - Street 1:1340 AIRPORT COMMERCE DRIVE
Practice Address - Street 2:SUITE # 350
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741
Practice Address - Country:US
Practice Address - Phone:800-880-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008119183500000X
TN33929183500000X
MI5302037563183500000X
TX47358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist