# DOUGHERTYS LTC PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DOUGHERTY'S LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578093183
- **Authorized official:** ANDREW KOMUVES (PRESIDENT&CEO)
- **Authorized official phone:** (972) 860-0229

## Contact information

- **Practice address:** 5959 ROYAL LN STE 513, DALLAS, TX 75230-3856
- **Practice address phone:** (214) 373-5301
- **Practice address fax:** (214) 373-5333
- **Mailing address:** 5959 ROYAL LN, SUITE 513, DALLAS, TX 75230-3856
- **Mailing address phone:** (214) 373-5301
- **Mailing address fax:** (214) 373-5333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 31452 | TX | Yes |

## Other

- **Enumeration date:** 06/15/2017
- **Last updated:** 09/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2169947 | PK | — |
| 05 | — | 351064 | — | TX |