Dallas Healthcare Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27397 Issued in TX

Legal business name

DALLAS HEALTHCARE PHARMACY LLC

Doing business as

Dallas Healthcare Pharmacy

Practice address

4131 S Buckner Blvd
Suite a
Dallas, TX 75227-4318

Phone

(214) 388-5334

Fax

(214) 388-4355

NPI assigned

Feb 23, 2011

Last updated

Feb 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Graves

Title

Owner/Manager

Phone

(469) 387-5661

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dallas Healthcare Pharmacy Doing business as

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1245537505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD",
            "address_2": "SUITE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-5334",
            "fax_number": "214-388-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD",
            "address_2": "SUITE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-5334",
            "fax_number": "214-388-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS HEALTHCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "469-387-5661"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dallas Healthcare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Feb 20, 2017; 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.