Joe Buck Park, R. PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

15052 Issued in TX

Practice address

515 Preston Royal Village
Dougherty'S Pharmacy Inc.
Dallas, TX 75230

Phone

(214) 363-4318

Fax

(214) 363-6570

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174626436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 HUNTINGTON DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802810",
            "telephone_number": "972-234-1920",
            "fax_number": "214-363-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PRESTON ROYAL VILLAGE",
            "address_2": "DOUGHERTY'S PHARMACY INC.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "214-363-4318",
            "fax_number": "214-363-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOE",
        "middle_name": "BUCK",
        "credential": "R. PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "15052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "15052",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hawon Park, DPT
• Isabel Park
• Jason J. Park, MD
• Jason Young Park, MD
• Jeong Ben Park, MD
• Joonho Park, M.D.
• Ki Eun Park, M.D.
• Krystal Blair Park
• Marisol Park, LPC
• Minkyung Park, M.D.

• Pharmacist in Dallas, TX
• Providers in Dallas, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.