Organization
DOUGHERTYS PHARMACY INC
Active
Other names
Dougherty's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY DEWITT (CEO)
(254) 722-7912
Entity
Organization
Contact information
Practice address
12835 PRESTON RD STE 202, DALLAS, TX 75230-1277
(214) 373-5300
(214) 739-0238
Mailing address
12835 PRESTON RD STE 202, DALLAS, TX 75230-1277
(214) 373-5300
(214) 739-0238
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
03246
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086333401
—
TX
01
—
2099454
PK
—
Enumeration date
09/02/2005
Last updated
11/15/2021
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