Healthcare Provider Details

I. General information

NPI: 1255341293
Provider Name (Legal Business Name): DUSEK PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W 1ST ST
CAMERON TX
76520-3302
US

IV. Provider business mailing address

PO BOX 431
CAMERON TX
76520-0431
US

V. Phone/Fax

Practice location:
  • Phone: 254-697-2111
  • Fax: 254-697-4039
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number00269
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEVIN HARMON
Title or Position: PARTNER
Credential:
Phone: 254-697-2111