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Organization

DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER

Active
Other names
The Center Pharmacy at Legacy Oaks
Organization subpart
No

Provider details

NPI number
Authorized official
MARK EDERY (DIRECTOR OF PHARMACY)
(214) 743-6180
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
Primary
30327
TX
3336M0002X
Mail Order Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2155306
PK
05
468501
TX
Enumeration date
11/18/2015
Last updated
03/06/2017
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