Dougherty'S Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

16496 Issued in TX

Legal business name

DOUGHERTY'S PHARMACY INC.

Practice address

515 Preston Royal Village
Dallas, TX 75230

Phone

(214) 363-6558

Fax

(214) 363-6570

NPI assigned

Sep 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joe Buck Park, R.PH.

Title

President

Phone

(214) 363-6558

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba Dougherty's Home Care Pharmacy Doing business as

Tax ID family

Dba Dougherty'S Home Care Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Doughertys Pharmacy Inc

  • Long Term Care Pharmacy
  • Dallas, TX
  • NPI 1083637987
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1093817439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PRESTON ROYAL VILLAGE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "214-363-6558",
            "fax_number": "214-363-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PRESTON ROYAL VILLAGE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "214-363-6558",
            "fax_number": "214-363-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGHERTY'S PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "BUCK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-363-6558",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "16496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320153",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Dougherty's Home Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doug Michael Dougherty, THM MED LPC
• Jennifer Lynn Dougherty, PH.D.
• Michael Dougherty
• Mitchell Reid Dougherty, DC
• Patrick Kelly Dougherty, MPAS, PA-C
• Doughertys LTC Pharmacy LLC
• Doughertys Pharmacy Inc
• Doughertys Pharmacy Inc
• Doughertys Pharmacy Inc
• Kyle Edward Doughty, M.D.

• Community/Retail Pharmacy in Dallas, TX
• Providers in Dallas, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.