MEDICARE: DR. ALAN ROACH RPH, DPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	27311	TX

General Provider Information

NPI Number	:	1972500395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN ROACH RPH, DPH

Provider Business Mailing Address
First Line	:	1700 YELLOWSTONE AVE
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75077-2466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 N BECKLEY AVE
Second Line	:	METHODIST HOSPITAL OF DALLAS
City	:	DALLAS
State	:	TX
Zip	:	75203-1201
Country	:	US
Telephone Number	:	214-947-2400
Fax Number	:	214-947-2501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	04/28/2008

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