NPIMap

Organization Active NPI

University of Texas Southwestern Medical Center at Dallas

Doing business as UT Southwestern Campus Pharmacy

  • Community/Retail Pharmacy
  • Dallas, TX
National Provider Identifier
1609420025
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Doing business as
UT Southwestern Campus Pharmacy
Practice address
5303 Harry Hines Blvd
Suite 100 James Aston Ambulatory Care Center
Dallas, TX 75390-8862
Phone
(214) 648-2422
Fax
(214) 648-2652
NPI assigned
Jul 25, 2019
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mark Alan Meyer
Title
Cfo
Phone
(214) 633-4804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

5303 Harry Hines Blvd
Suite 100 James Aston Ambulatory Care Center
Dallas, TX 75390-8862

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-9922
Phone (469) 525-5908

Other identifiers 4

IdentifierTypeStateIssuer
23929OtherTXTSBP
4589341OtherTXNCPDP
B0138718OtherTXDPS
149455OtherTXVENDOR DRUG PROGRAM

Other names 1

  • UT Southwestern Campus Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171117002750 TX Part B Supplier - Pharmacy 0143271395 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frisco, TX; Fort Worth, TX; Dallas, TX
O20200403000203 TX DME Supplier - PharmacyDME Supplier - Hospital 0143271395 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, TX

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Ut Southwestern Clinical

Locations

5303 Harry Hines Blvd
Ste 100
Ut Southwest Medical Center, TX 75390
Phone (214) 648-2422

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609420025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909922",
            "telephone_number": "469-525-5908",
            "fax_number": "214-648-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 HARRY HINES BLVD",
            "address_2": "SUITE 100 JAMES ASTON AMBULATORY CARE CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908862",
            "telephone_number": "214-648-2422",
            "fax_number": "214-648-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "enumeration_date": "2019-07-25",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "214-633-4804"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBP",
            "identifier": "23929",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4589341",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "B0138718",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR DRUG PROGRAM",
            "identifier": "149455",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UT Southwestern Campus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UT Southwestern Campus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.