Doughertys Pharmacy Humble LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29517 Issued in TX

Legal business name

DOUGHERTYS PHARMACY HUMBLE LLC

Doing business as

Humble & Pacific Pharmacy

Practice address

211 FM 1960 Bypass Rd E
Humble, TX 77338-3605

Phone

(281) 446-9191

Fax

(281) 446-2329

NPI assigned

Oct 24, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Mykel Walker

Title

Authorized Official

Phone

(281) 446-9191

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Humble & Pacific Pharmacy Doing business as

Electronic endpoints 1

Tax ID family

Doughertys Pharmacy Humble LLC2 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 Humble LLC

  • Community/Retail Pharmacy
  • Humble, TX
  • NPI 1679119093
  NPD tax ID

Locations

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1679978290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FM 1960 BYPASS RD E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773383605",
            "telephone_number": "281-446-9191",
            "fax_number": "281-446-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FM 1960 BYPASS RD E",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773383605",
            "telephone_number": "281-446-9191",
            "fax_number": "281-446-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGHERTYS PHARMACY HUMBLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MYKEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "281-446-9191",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147047",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148865",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwalker@humbleandpacific.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "211 Fm 1960 Bypass Rd E",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773383605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Humble & Pacific Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Humble & Pacific Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nikita Marie Dorsett
• Lakisha Dorsey, ATC, LAT, CES
• John Edward Doucet Jr., LSA
• Lori Doucet, BCBA
• Doughertys Pharmacy Humble LLC
• Reene Naidoo Douglas, M.D.
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• Doyfran Developers LLC
• Dr Aftab S. Ahmad MD Family Practice, PLLC
• Dr Caroline Le Dental PLLC

• Community/Retail Pharmacy in Humble, TX
• Providers in Humble, 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 Nov 25, 2020; 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.