Doughertys LTC Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

31452 Issued in TX

Legal business name

DOUGHERTYS LTC PHARMACY LLC

Practice address

5959 Royal LN Ste 513
Dallas, TX 75230-3856

Phone

(214) 373-5301

Fax

(214) 373-5333

NPI assigned

Jun 15, 2017

Organization subpart

No

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

Authorized official

Name

Andrew Komuves

Title

President&Ceo

Phone

(972) 860-0229

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DOUGHERTY'S LTC PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1578093183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 ROYAL LN",
            "address_2": "SUITE 513",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303856",
            "telephone_number": "214-373-5301",
            "fax_number": "214-373-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 ROYAL LN STE 513",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303856",
            "telephone_number": "214-373-5301",
            "fax_number": "214-373-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGHERTYS LTC PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "KOMUVES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT&CEO",
        "authorized_official_telephone_number": "972-860-0229"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "31452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351064",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2169947",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOUGHERTY'S LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DOUGHERTY'S LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lynn Dougherty, PH.D.
• Michael Dougherty
• Mitchell Reid Dougherty, DC
• Patrick Kelly Dougherty, MPAS, PA-C
• Dougherty'S Pharmacy Inc.
• Doughertys Pharmacy Inc
• Doughertys Pharmacy Inc
• Doughertys Pharmacy Inc
• Kyle Edward Doughty, M.D.
• Douglas Avenue Medical Management Co

• Long Term Care Pharmacy in Dallas, TX
• Providers in Dallas, TX by specialty
• Long Term Care Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.