# DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Center Pharmacy at Legacy Oaks
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861866568
- **Authorized official:** MARK EDERY (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (214) 743-6180

## Contact information

- **Practice address:** 5372 FREDERICKSBURG RD STE 110, SAN ANTONIO, TX 78229-3559
- **Practice address phone:** (210) 971-5803
- **Practice address fax:** (210) 714-7771
- **Mailing address:** 5372 FREDERICKSBURG RD STE 110, SAN ANTONIO, TX 78229-3559
- **Mailing address phone:** (210) 971-5803
- **Mailing address fax:** (210) 714-7771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | 30327 | TX | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/18/2015
- **Last updated:** 03/06/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2155306 | PK | — |
| 05 | — | 468501 | — | TX |