Healthcare Provider Details

I. General information

NPI: 1518876259
Provider Name (Legal Business Name): CHAYSE CLARK DILLARD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 HIGHWAY 16
COMANCHE TX
76442-4462
US

IV. Provider business mailing address

405 E DUNCAN AVE
COMANCHE TX
76442-2538
US

V. Phone/Fax

Practice location:
  • Phone: 254-879-4980
  • Fax: 254-879-4969
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number72486
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: