Organization
DALLAS HEALTHCARE PHARMACY LLC
Active
Other names
Dallas Healthcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GRAVES (OWNER/MANAGER)
(469) 387-5661
Entity
Organization
Contact information
Practice address
4131 S BUCKNER BLVD, SUITE A, DALLAS, TX 75227-4318
(214) 388-5334
(214) 388-4355
Mailing address
4131 S BUCKNER BLVD, SUITE A, DALLAS, TX 75227-4318
(214) 388-5334
(214) 388-4355
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27397
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129014
PK
—
Enumeration date
02/23/2011
Last updated
02/20/2017
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