Organization
DALLAS COMPOUNDING PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BARRETT (OWNER)
(214) 288-2117
Entity
Organization
Contact information
Practice address
3001 A GASTON AVE, DALLAS, TX 75226
(214) 824-2553
(214) 824-2740
Mailing address
3001 A GASTON AVE, DALLAS, TX 75226
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24807
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4540729
OTHER ID NUMBER
—
Enumeration date
07/22/2006
Last updated
07/20/2007
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