Organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Active
Other names
UTSW Moncrief Med Ctr Pharmacy at Fort Worth
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN MEYER (CFO)
(214) 633-4804
Entity
Organization
Contact information
Practice address
600 S MAIN ST STE 1.102, FORT WORTH, TX 76104-2410
(817) 882-2500
(817) 882-2501
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9222
(469) 525-5908
(817) 882-2501
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171740
PK
—
Enumeration date
10/06/2017
Last updated
11/24/2025
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