NPIMap

Organization Active NPI

University of Texas Southwestern Medical Center at Dallas

Doing business as UTSW Frisco MOB Retail Pharmacy

  • Community/Retail Pharmacy
  • Frisco, TX
National Provider Identifier
1780214114
Registry record updated May 4, 2021
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
UTSW Frisco MOB Retail Pharmacy
Practice address
12500 Dallas Pwky
Ste 1.200
Frisco, TX 75033
Phone
(469) 604-9100
NPI assigned
Jan 24, 2020
Last updated
May 4, 2021By 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 May 4, 2021

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

12500 Dallas Pwky
Ste 1.200
Frisco, TX 75033

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-9222
Phone (469) 525-5908

Other names 1

  • UTSW Frisco MOB Retail 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
O20201222002008 TX DME Supplier - Pharmacy 0143271395 Practice locations: Frisco, TX

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Utsw Frisco Mob Retail Pharmacy12500 Dallas Pkwy, Frisco, TX 75033-4231(469) 604-9100 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 2, 2019

National Provider Directory

National Provider Directory
Tax ID family
Ut Southwestern Clinical11 organizations share this tax ID, including this one
Part of
Ut Southwestern Clinical

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12500 Dallas Pkwy
Ste 1200
Frisco, TX 75033
Phone (469) 604-9100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ut Southwestern University HospitalDallas, TX, CCN 450044 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2005
Jan 1, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1780214114",
    "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": "753909222",
            "telephone_number": "469-525-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 DALLAS PWKY",
            "address_2": "STE 1.200",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033",
            "telephone_number": "469-604-9100"
        }
    ],
    "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": "2020-01-24",
        "last_updated": "2021-05-04",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTSW Frisco MOB Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UTSW Frisco MOB Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.