NPIMap

Organization Active NPI

Dallas County Mental Health & Mental Retardation Center

Doing business as The Center Pharmacy at Legacy Oaks

  • Clinic Pharmacy
  • San Antonio, TX
National Provider Identifier
1861866568
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
30327 Issued in TX
Legal business name
DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER
Doing business as
The Center Pharmacy at Legacy Oaks
Practice address
5372 Fredericksburg Rd Ste 110
San Antonio, TX 78229-3559
Phone
(210) 971-5803
Fax
(210) 714-7771
NPI assigned
Nov 18, 2015
Last updated
Mar 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Authorized official

Name
Mark Edery
Title
Director of Pharmacy
Phone
(214) 743-6180

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X 30327 TX Primary
Mail Order Pharmacy 3336M0002X NU

Addresses

Primary practice location

5372 Fredericksburg Rd Ste 110
San Antonio, TX 78229-3559

Mailing address

5372 Fredericksburg Rd Ste 110
San Antonio, TX 78229-3559
Phone (210) 971-5803

Other identifiers 2

IdentifierTypeStateIssuer
2155306OtherPK
468501MedicaidTX

Other names 1

  • The Center Pharmacy at Legacy Oaks Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dallas County MHMR32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

5372 Fredericksburg Rd
Ste 110
San Antonio, TX 78229
Phone (210) 971-5803

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1861866568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5372 FREDERICKSBURG RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293559",
            "telephone_number": "210-971-5803",
            "fax_number": "210-714-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372 FREDERICKSBURG RD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293559",
            "telephone_number": "210-971-5803",
            "fax_number": "210-714-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "EDERY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "214-743-6180"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "TX",
            "license": "30327",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155306",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "468501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center Pharmacy at Legacy Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.