Organization
DOUGHERTYS PHARMACY EL PASO LLC
Active
Other names
McCrory's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KOMUVES (PRESIDENT&CEO)
(214) 373-5399
Entity
Organization
Contact information
Practice address
6151 DEW DR STE 100, EL PASO, TX 79912-3912
(915) 581-9655
(915) 587-6556
Mailing address
16250 KNOLL TRAIL DR, SUITE 102, DALLAS, TX 75248-2874
(972) 860-0201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29778
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147073
—
TX
01
—
2149867
PK
—
Enumeration date
01/27/2015
Last updated
04/12/2017
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